Brookwood Primary Care- Grand River, L.l.c.

NPI #1053794354 in Leeds, Alabama

Provider Information

NPI Number: 1053794354
Entity Type: Organization
Organization Name: Brookwood Primary Care- Grand River, L.l.c.
Primary Specialty: Family Medicine
Enumeration Date: Jul 6, 2015
Last Updated: May 26, 2016

Practice Location

Address: 1115 PAYTON WAY.
Address 2: SUITE 111
City: Leeds
State: Alabama
ZIP Code: 35094
Phone: (205) 352-1175

Authorized Official

Name: MR. MICHAEL KYLE BURTNETT
Title: SVP, OUTPATIENT SERVICES, TENET
Phone: (469) 893-2902

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine - Sports Medicine — Sports Medicine	207QS0010X
Family Medicine	207Q00000X	Primary

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