Healthcare Provider Details

I. General information

NPI: 1821446881
Provider Name (Legal Business Name): UNIVERSITY SLEEP DISORDERS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 06/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 E UNIVERSITY DR
AUBURN AL
36832-6725
US

IV. Provider business mailing address

3368 HIGHWAY 280
ALEXANDER CITY AL
35010-3393
US

V. Phone/Fax

Practice location:
  • Phone: 334-209-6555
  • Fax: 256-329-3339
Mailing address:
  • Phone: 256-329-1114
  • Fax: 256-329-2202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173F00000X
TaxonomySleep Specialist (PhD)
License NumberMD.16702
License Number StateAL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: FRED ANTHONY MCLEOD
Title or Position: SLEEP SPECIALIST
Credential: MD
Phone: 256-329-1114