Heritage Family Medicine

LBN: Dawn B Mancuso, Md, Llc
Heritage Family Medicine is an health care organization with primary practice located at 12205 County Line Rd Suite B, Madison AL 35758-7719. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Dawn B Mancuso, Md, Llc can be contacted via phone (256) 990-8446, or through Mancuso, Anthony G via phone (256) 990-8446.

Contact Information

Primary practice address
12205 County Line Rd Suite B Madison AL 35758-7719
Phone: (256) 990-8446
Fax: (256) 461-0393
Website:
Map and Directions
Authorized official contact:
Name: Mancuso, Anthony G
Phone: (256) 990-8446

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 00015990 Alabama

Profile Details

NPI number 1114141744
LBN Legal business name Dawn B Mancuso, Md, Llc
DBA Doing business as Heritage Family Medicine
Authorized official Mancuso, Anthony G
Entity Organization
Organization subpart 1 No
Enumeration date Apr 13th, 2007
Last updated Dec 7th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114141744 NPPES
Alabama MEDICAID 529910550
Alabama Other 051506404

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