Healthcare Provider Details

I. General information

NPI: 1396035101
Provider Name (Legal Business Name): EAST ALABAMA ALLERGY AND ASTHMA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2011
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 E GLENN AVE STE 101
AUBURN AL
36830-5729
US

IV. Provider business mailing address

1925 E GLENN AVE STE 101
AUBURN AL
36830-5729
US

V. Phone/Fax

Practice location:
  • Phone: 334-528-0078
  • Fax: 334-528-0079
Mailing address:
  • Phone: 334-528-0078
  • Fax: 334-528-0079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberDO.1138
License Number StateAL

VIII. Authorized Official

Name: DR. JOHN W. TOLE
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 334-528-0078