Healthcare Provider Details
I. General information
NPI: 1760447510
Provider Name (Legal Business Name): ANNISTON OBGYN ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/17/2006
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
901 LEIGHTON AVE SUITE 501
ANNISTON AL
36207-5700
US
IV. Provider business mailing address
901 LEIGHTON AVE SUITE 501
ANNISTON AL
36207-5700
US
V. Phone/Fax
- Phone: 256-237-6755
- Fax: 256-236-1823
- Phone: 256-237-6755
- Fax: 256-236-1823
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VX0000X |
| Taxonomy | Obstetrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KELLEY
SNIDER
Title or Position: ADMINISTRATOR
Credential:
Phone: 256-237-6755