Healthcare Provider Details

I. General information

NPI: 1528251642
Provider Name (Legal Business Name): HEMATOLOGY AND ONCOLOGY ASSOCIATES OF ALABAMA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 01/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 LEIGHTON AVE SUITE 402
ANNISTON AL
36207-5700
US

IV. Provider business mailing address

PO BOX 10327
BIRMINGHAM AL
35202-0327
US

V. Phone/Fax

Practice location:
  • Phone: 256-237-2526
  • Fax: 256-237-4968
Mailing address:
  • Phone: 205-502-4712
  • Fax: 205-502-4710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ELQUIS M. CASTILLO
Title or Position: PRESIDENT
Credential: MD
Phone: 205-502-4712