National Provider Identifier Database

BEAVERTON FAMILY MEDICINE LLC
Family


Contact Information

BEAVERTON FAMILY MEDICINE LLC
12815 HIGHWAY 278
BEAVERTON, AL35544-2954
Phone: 205-606-1200
Fax:
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for BEAVERTON FAMILY MEDICINE LLC

NPI Number 1578240511
Legal business name
LBN
BEAVERTON FAMILY MEDICINE LLC
Authorized official MICHAEL BUTLER - (PRACTICE MANAGER)
Entity Organization
Organization subpart No
Enumeration date 06/30/2023
Last updated 07/14/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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