Healthcare Provider Details

I. General information

NPI: 1659157113
Provider Name (Legal Business Name): ALABAMA COLON & RECTAL INSTITUTE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2023
Last Update Date: 08/31/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 4TH AVENUE SOUTH
BIRMINGHAM AL
35233
US

IV. Provider business mailing address

1317 4TH AVENUE SOUTH
BIRMINGHAM AL
35233
US

V. Phone/Fax

Practice location:
  • Phone: 205-458-5000
  • Fax: 844-692-0014
Mailing address:
  • Phone:
  • Fax:

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: JON ROSSER
Title or Position: PRESIDENT, PHYSICIAN
Credential:
Phone: 205-458-5000