| Organization Name: | HAZEL GREEN PRIMARY CARE |
| NPI Number: | 1578645396 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HEATHER MASON (DIRECTOR OF PHYSICIANS NETWORK) |
| Mailing Address: | 13596 Highway 231 431 N Suite 4 Hazel Green |
| State: | AL US |
| Postal Code: | 357508617 |
| Phone Number: | 2568290610 |
| Fax Number: | 2568291371 |
| NPI Enumeration Date: | 10/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |