MEDICARE: DR. KEVIN LEONARD SUBLETT M.D.F.A.C.C.

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
1	207RC0000X	Cardiovascular Disease Physician	00015380	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710080734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN LEONARD SUBLETT M.D.F.A.C.C.

Provider Business Mailing Address
First Line	:	3368 HIGHWAY 280
Second Line	:	SUITE 130
City	:	ALEXANDER CITY
State	:	AL
Zip	:	35010-3393
Country	:	US
Telephone Number	:	256-234-2644
Fax Number	:	256-234-2704

Provider Business Practice Location Address
First Line	:	3368 HIGHWAY 280
Second Line	:	SUITE 130
City	:	ALEXANDER CITY
State	:	AL
Zip	:	35010-3393
Country	:	US
Telephone Number	:	256-234-2644
Fax Number	:	256-234-2704

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	09/29/2014

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Directions to “ DR. KEVIN LEONARD SUBLETT M.D.F.A.C.C.” Practice Location

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