Basic Information
| Provider Information | |||||||||
| NPI: | 1295907889 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SEALE HARRIS CLINIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 805 SAINT VINCENTS DR | ||||||||
| Address2: | SUITE 510 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352051636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2055955504 | ||||||||
| FaxNumber: | 2055923427 | ||||||||
| Practice Location | |||||||||
| Address1: | 805 SAINT VINCENTS DR | ||||||||
| Address2: | SUITE 510 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352051636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2055955504 | ||||||||
| FaxNumber: | 2055923427 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2008 | ||||||||
| LastUpdateDate: | 01/17/2011 | ||||||||
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| AuthorizedOfficialLastName: | CRENSHAW | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2055955504 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD.27684 | AL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.