Basic Information
| Provider Information | |||||||||
| NPI: | 1548510050 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EATRIGHT WEIGHT LOSS CENTER OF HUNTSVILLE HOSPITAL | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | THE HEALTH CARE AUTHORITY OF THE CITY OF HUNSTVILLE | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 930 FRANKLIN ST SE | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358014312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565198282 | ||||||||
| FaxNumber: | 2562658327 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 SIVLEY RD SW | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358015134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2562653072 | ||||||||
| FaxNumber: | 2562653073 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2012 | ||||||||
| LastUpdateDate: | 09/13/2012 | ||||||||
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| AuthorizedOfficialLastName: | MASON | ||||||||
| AuthorizedOfficialFirstName: | HEATHER | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR PHYSICIAN NETWORK | ||||||||
| AuthorizedOfficialTelephone: | 2562657766 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.