Healthcare Provider Details

I. General information

NPI: 1073602173
Provider Name (Legal Business Name): RAULERSON & RAULERSON PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 04/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 BELLEVILLE AVE
BREWTON AL
36426-1304
US

IV. Provider business mailing address

1205 BELLEVILLE AVE.
BREWTON AL
36426
US

V. Phone/Fax

Practice location:
  • Phone: 251-867-3606
  • Fax: 251-867-3610
Mailing address:
  • Phone: 251-867-3606
  • Fax: 251-867-3610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JAMES D. RAULERSON
Title or Position: CEO/PHYSICIAN
Credential: M.D.
Phone: 251-867-3606