Basic Information
| Provider Information | |||||||||
| NPI: | 1942351762 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BHC-HOOVER INTERNAL MEDICINE ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3201 4TH AVE S | ||||||||
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| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352221723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057155943 | ||||||||
| FaxNumber: | 2057155932 | ||||||||
| Practice Location | |||||||||
| Address1: | 5295 PRESERVE PKWY | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | HOOVER | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352444701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2056829124 | ||||||||
| FaxNumber: | 2056827746 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2007 | ||||||||
| LastUpdateDate: | 12/15/2011 | ||||||||
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| AuthorizedOfficialLastName: | FENN | ||||||||
| AuthorizedOfficialFirstName: | GEORGE | ||||||||
| AuthorizedOfficialMiddleName: | SCOTT | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2057155415 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | BAPTIST HEALTH CENTERS, INC | ||||||||
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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.