| North Shelby Family Health | |
|
2520 Valleydale Rd Birmingham AL 35244-2019 | |
| (205) 980-9944 | |
| (205) 980-9844 |
| Full Name | North Shelby Family Health |
|---|---|
| Speciality | Family Medicine |
| Location | 2520 Valleydale Rd, Birmingham, Alabama |
| Authorized Official Name and Position | Carol J Sims (OFFICE MANAGER) |
| Authorized Official Contact | 2059809944 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Shelby Family Health 2520 Valleydale Rd Birmingham AL 35244-2019 Ph: (205) 980-9944 | North Shelby Family Health 2520 Valleydale Rd Birmingham AL 35244-2019 Ph: (205) 980-9944 |
| NPI Number | 1508976598 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 10/18/2010 |
| Medicare PECOS PAC ID | 4981623006 |
|---|---|
| Medicare Enrollment ID | O20051117000964 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508976598 | NPI | - | NPPES |
| 529700260 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Vance Gerald Blackburn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720068463 PECOS PAC ID: 7810994290 Enrollment ID: I20100825000156 |
| Provider Name | Douglas Owen Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659351302 PECOS PAC ID: 5092712471 Enrollment ID: I20100827000050 |
| Provider Name | Nicole Speegle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831585843 PECOS PAC ID: 9537477294 Enrollment ID: I20150929001697 |
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