| Self Center Pc | |
|
306 S Greeno Rd Suite A Fairhope AL 36532-1905 | |
| (251) 928-8760 | |
| (251) 928-7028 |
| Full Name | Self Center Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 306 S Greeno Rd, Fairhope, Alabama |
| Authorized Official Name and Position | Karl Stanley Self (OWNER) |
| Authorized Official Contact | 2519288760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Self Center Pc 306 S Greeno Rd Suite A Fairhope AL 36532-1905 Ph: (251) 928-8760 | Self Center Pc 306 S Greeno Rd Suite A Fairhope AL 36532-1905 Ph: (251) 928-8760 |
| NPI Number | 1083832968 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 06/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083832968 | NPI | - | NPPES |
| 51083390 | Other | AL | BLUE CROSS/BLUESHIELD OF ALABAMA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 6916 (Alabama) | Primary |
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