Healthcare Provider Details

I. General information

NPI: 1417022237
Provider Name (Legal Business Name): ALABAMA ORTHOPAEDIC CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 06/01/2020
Certification Date: 06/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 US HIGHWAY 98 STE 203
DAPHNE AL
36526-9512
US

IV. Provider business mailing address

3610 SPRINGHILL MEMORIAL DR N
MOBILE AL
36608-1162
US

V. Phone/Fax

Practice location:
  • Phone: 251-621-2501
  • Fax: 251-621-2502
Mailing address:
  • Phone: 251-626-2501
  • Fax: 251-626-2502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number056904
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number056904
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number056904
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number056904
License Number StateAL
# 5
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number056904
License Number StateAL
# 6
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number056904
License Number StateAL
# 7
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number056904
License Number StateAL

VIII. Authorized Official

Name: MR. ROBERT DEAN BROWN
Title or Position: CEO
Credential:
Phone: 251-410-3600