Eufaula Family Medicine

Organization Active NPI Family Medicine Physician · Eufaula, AL

NPI 1023216801 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1023216801
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
22858 (AL)
Legal business name
EUFAULA FAMILY MEDICINE
Practice address
617 E Broad St
B
Eufaula, AL 36027
Phone
(334) 687-0112
Fax
(334) 687-0113
NPI assigned
Jul 3, 2007
Organization subpart
No

Authorized official

Name
Richard Shack, MD
Title
Owner
Phone
(334) 687-0112

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X 22858 AL Yes

Addresses

Primary practice location

617 E Broad St
B
Eufaula, AL 36027

Mailing address

617 E Broad St
B
Eufaula, AL 36027
Phone (334) 687-0112

Other providers in Eufaula, AL

All providers in Eufaula, AL · Family Medicine Physician in Alabama

Sources for this page

Verify at the official NPI Registry.