Healthcare Provider Details

I. General information

NPI: 1568374395
Provider Name (Legal Business Name): EAST ALABAMA OBGYN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 LAKESIDE CIR
AUBURN AL
36830-2842
US

IV. Provider business mailing address

1800 LAKESIDE CIR
AUBURN AL
36830-2842
US

V. Phone/Fax

Practice location:
  • Phone: 334-528-2538
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL A PRICE JR.
Title or Position: CFO
Credential:
Phone: 334-528-1310