Healthcare Provider Details

I. General information

NPI: 1033443775
Provider Name (Legal Business Name): HEMATOLOGY & ONCOLOGY ASSOCIATES OF ALABAMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2009
Last Update Date: 03/19/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 WALKER CHAPEL PLAZA SUITE 109
FULTONDALE AL
35068
US

IV. Provider business mailing address

PO BOX 131329
BIRMINGHAM AL
35213-6329
US

V. Phone/Fax

Practice location:
  • Phone: 205-502-4700
  • Fax: 205-502-5183
Mailing address:
  • Phone: 205-271-8541
  • Fax: 205-271-8555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: ELQUIS M. CASTILLO
Title or Position: PRESIDENT
Credential: MD
Phone: 205-271-8541