Healthcare Provider Details

I. General information

NPI: 1679642805
Provider Name (Legal Business Name): ALABAMA NEUROLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3105 INDEPENDENCE DR STE 105
BIRMINGHAM AL
35209-4111
US

IV. Provider business mailing address

3105 INDEPENDENCE DR STE 105
BIRMINGHAM AL
35209-4111
US

V. Phone/Fax

Practice location:
  • Phone: 205-803-2210
  • Fax: 205-803-2214
Mailing address:
  • Phone: 205-580-2210
  • Fax: 205-803-2214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number12140
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN BYRON RISER
Title or Position: PRESIDENT
Credential: MD
Phone: 205-803-2210