Provider Demographics
NPI:1780343384
Name:DISCOVERY MEDICAL CENTER LLC
Entity type:Organization
Organization Name:DISCOVERY MEDICAL CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMMY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MCGOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:256-533-2900
Mailing Address - Street 1:502 PRATT AVE NE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6317
Mailing Address - Country:US
Mailing Address - Phone:256-533-2900
Mailing Address - Fax:256-533-1333
Practice Address - Street 1:7914 MEMORIAL PKWY SW STE E18
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-2218
Practice Address - Country:US
Practice Address - Phone:256-881-1321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DISCOVERY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-10
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty