Healthcare Provider Details

I. General information

NPI: 1932190188
Provider Name (Legal Business Name): JAMES RANDALL AUSTIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9511 US HIGHWAY 431
ALBERTVILLE AL
35950-0128
US

IV. Provider business mailing address

9511 US HIGHWAY 431
ALBERTVILLE AL
35950-0128
US

V. Phone/Fax

Practice location:
  • Phone: 256-891-7001
  • Fax: 256-891-2398
Mailing address:
  • Phone: 256-891-7001
  • Fax: 256-891-2398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberDO272
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: