| Cantwell Family Psychiatry, Llc | |
|
770 Middle St Fairhope AL 36532-1766 | |
| (251) 517-5800 | |
| (251) 517-5801 |
| Full Name | Cantwell Family Psychiatry, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 770 Middle St, Fairhope, Alabama |
| Authorized Official Name and Position | John Joseph Broderick-cantwell (OWNER) |
| Authorized Official Contact | 2515175800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cantwell Family Psychiatry, Llc Po Box 392 Fairhope AL 36533-0392 Ph: (251) 517-5800 | Cantwell Family Psychiatry, Llc 770 Middle St Fairhope AL 36532-1766 Ph: (251) 517-5800 |
| NPI Number | 1033649298 |
|---|---|
| Provider Enumeration Date | 06/19/2017 |
| Last Update Date | 01/10/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033649298 | NPI | - | NPPES |
| 28950 | Other | AL | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 28950 (Alabama) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
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