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NPI Code Detail

MEDICARE: ALPHA NEURON, LLC

MEDICARE: ALPHA NEURON, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician
2363LF0000XFamily Nurse Practitioner
32084N0400XNeurology Physician

General Provider Information

NPI Number : 1477162576
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALPHA NEURON, LLC
Provider Business Mailing Address
First Line : 2201 JACK WARNER PKWY
Second Line :
City : TUSCALOOSA
State : AL
Zip : 35401-1090
Country : US
Telephone Number : 205-523-5618
Fax Number :
Provider Business Practice Location Address
First Line : 2201 JACK WARNER PKWY
Second Line :
City : TUSCALOOSA
State : AL
Zip : 35401-1090
Country : US
Telephone Number : 205-523-5618
Fax Number :
Authorized Official
Title or Position : PRACTICE MANAGER
Name : MICHELLE HAWTHORNE
Credential : MS
Telephone Number : 205-292-2428
Provider Enumeration Date : 07/24/2020
Last Update Date : 08/12/2021

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Directions to “ALPHA NEURON, LLC ” Practice Location

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