Healthcare Provider Details

I. General information

NPI: 1306974498
Provider Name (Legal Business Name): SOUTH AL SLEEP CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1865 HONEYSUCKLE RD STE 3
DOTHAN AL
36305-4287
US

IV. Provider business mailing address

1865 HONEYSUCKLE RD STE 3
DOTHAN AL
36305-4287
US

V. Phone/Fax

Practice location:
  • Phone: 334-792-6802
  • Fax: 334-792-6822
Mailing address:
  • Phone: 334-792-6802
  • Fax: 334-792-6822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number012157
License Number StateAL

VIII. Authorized Official

Name: SYED A HUSSAIN
Title or Position: DIRECTOR
Credential:
Phone: 334-792-6802