Provider Demographics
NPI:1154362655
Name:COMPLETE FAMILY MEDICINE
Entity type:Organization
Organization Name:COMPLETE FAMILY MEDICINE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-737-9416
Mailing Address - Street 1:PO BOX 638
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35056-0638
Mailing Address - Country:US
Mailing Address - Phone:256-737-9416
Mailing Address - Fax:256-736-5684
Practice Address - Street 1:1908 CHEROKEE AVE SW
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-5502
Practice Address - Country:US
Practice Address - Phone:256-737-9416
Practice Address - Fax:256-736-5684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Not Answered305R00000XManaged Care OrganizationsPreferred Provider OrganizationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051507133OtherBLUE CROSS
1366514945OtherNPI
AL1588603807OtherNPI
AL080148738OtherRRMC
AL1235175886OtherNPI
AL1629093638OtherNPI
AL009912575Medicaid
438170475OtherTRICARE
AL=========OtherGREAT WEST