Provider Demographics
NPI:1780977447
Name:CHELSEA URGENT CARE
Entity type:Organization
Organization Name:CHELSEA URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:PAYSON
Authorized Official - Last Name:DAUGHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:205-678-3924
Mailing Address - Street 1:15582 HWY 280
Mailing Address - Street 2:SUTE 106
Mailing Address - City:CHELSEA
Mailing Address - State:AL
Mailing Address - Zip Code:35043
Mailing Address - Country:US
Mailing Address - Phone:205-678-3924
Mailing Address - Fax:205-314-3307
Practice Address - Street 1:15582 HWY 280
Practice Address - Street 2:SUTE 106
Practice Address - City:CHELSEA
Practice Address - State:AL
Practice Address - Zip Code:35043
Practice Address - Country:US
Practice Address - Phone:205-678-3924
Practice Address - Fax:205-314-3307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO408207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty