Provider Demographics
NPI:1982444576
Name:BKG MEDICAL LLC
Entity type:Organization
Organization Name:BKG MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:256-762-0876
Mailing Address - Street 1:3264 BARKLEY BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HARTSELLE
Mailing Address - State:AL
Mailing Address - Zip Code:35640-7201
Mailing Address - Country:US
Mailing Address - Phone:256-762-0876
Mailing Address - Fax:256-217-5905
Practice Address - Street 1:3264 BARKLEY BRIDGE RD
Practice Address - Street 2:
Practice Address - City:HARTSELLE
Practice Address - State:AL
Practice Address - Zip Code:35640-7201
Practice Address - Country:US
Practice Address - Phone:256-762-0876
Practice Address - Fax:256-217-5905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-30
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty