Healthcare Provider Details

I. General information

NPI: 1548369382
Provider Name (Legal Business Name): CULLMAN ANESTHESIOLOGY & PAIN CONSULTANTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 03/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1912 AL HIGHWAY 157
CULLMAN AL
35058-0609
US

IV. Provider business mailing address

PO BOX 235022
MONTGOMERY AL
36123-5022
US

V. Phone/Fax

Practice location:
  • Phone: 256-737-2000
  • Fax: 256-737-2598
Mailing address:
  • Phone: 334-396-6930
  • Fax: 334-481-1200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBIN TATE HALL
Title or Position: PRESIDENT
Credential: MD
Phone: 334-396-6930