Basic Information
| Provider Information | |||||||||
| NPI: | 1316978588 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BHC-PALMER ORTHOPAEDICS AND SPORTS MEDICINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 BEACON PKWY W | ||||||||
| Address2: | SUITE 330 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352093102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057155910 | ||||||||
| FaxNumber: | 2057155928 | ||||||||
| Practice Location | |||||||||
| Address1: | 315 MEDICAL PARK | ||||||||
| Address2: | |||||||||
| City: | FORT PAYNE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35968 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2569979777 | ||||||||
| FaxNumber: | 2569979768 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BOYLE | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | E. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2057155901 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.