Healthcare Provider Details

I. General information

NPI: 1043839251
Provider Name (Legal Business Name): ADAM DEVINE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 LEIGHTON AVE STE 301
ANNISTON AL
36207-5703
US

IV. Provider business mailing address

PO BOX 1380
ANNISTON AL
36202-1380
US

V. Phone/Fax

Practice location:
  • Phone: 256-231-8644
  • Fax: 256-677-4944
Mailing address:
  • Phone: 256-235-5639
  • Fax: 256-231-2841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOT020296
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number4574
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: