Healthcare Provider Details

I. General information

NPI: 1871670497
Provider Name (Legal Business Name): ROY NOLEN ATTISON RPHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1532 HUFFMAN RD
BIRMINGHAM AL
35215-5621
US

IV. Provider business mailing address

1532 HUFFMAN RD
BIRMINGHAM AL
35215-5621
US

V. Phone/Fax

Practice location:
  • Phone: 205-853-1293
  • Fax:
Mailing address:
  • Phone: 205-853-1293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberT06930
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: