Healthcare Provider Details

I. General information

NPI: 1447271663
Provider Name (Legal Business Name): EASTERN UROLOGY ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 05/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 MEDICAL PARK DR E SUITE 350
BIRMINGHAM AL
35235-3400
US

IV. Provider business mailing address

48 MEDICAL PARK DR E SUITE 350
BIRMINGHAM AL
35235-3400
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-3040
  • Fax: 205-833-3627
Mailing address:
  • Phone: 205-838-3040
  • Fax: 205-833-3627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateAL

VIII. Authorized Official

Name: DR. ALEXANDER MONTGOMERY NADING JR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 205-838-3040