| Organization Name: | SELF AND SELF COMPANY, LLC |
| NPI Number: | 1174869820 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KARL STANLEY SELF (OWNER/PRESIDENT) |
| Mailing Address: | 306 Greeno Rd S Suite A Fairhope |
| State: | AL US |
| Postal Code: | 365321905 |
| Phone Number: | 2519288760 |
| Fax Number: | 2519287028 |
| NPI Enumeration Date: | 12/28/2012 |
| NPI Last Update Date: | 03/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |