Healthcare Provider Details

I. General information

NPI: 1588721773
Provider Name (Legal Business Name): ALABAMA COLON & RECTAL INSTITUTE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 4TH AVE S
BIRMINGHAM AL
35233-1408
US

IV. Provider business mailing address

1317 4TH AVE S
BIRMINGHAM AL
35233-1408
US

V. Phone/Fax

Practice location:
  • Phone: 205-458-5000
  • Fax: 205-458-5005
Mailing address:
  • Phone: 205-458-5000
  • Fax: 205-458-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAN J COYLE JR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 205-458-5000