Healthcare Provider Details
I. General information
NPI: 1992178628
Provider Name (Legal Business Name): NORTHERN ALABAMA PHYSICIANS, LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/03/2015
Last Update Date: 11/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4370 W MAIN ST
DOTHAN AL
36305-1056
US
IV. Provider business mailing address
PO BOX 602159
CHARLOTTE NC
28260-2159
US
V. Phone/Fax
- Phone: 334-793-5000
- Fax: 334-793-4613
- Phone: 800-210-7034
- Fax: 231-922-4030
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DERIK
K
KING
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 866-916-5259