Healthcare Provider Details

I. General information

NPI: 1669410700
Provider Name (Legal Business Name): PULMONARY AND SLEEP ASSOCIATES OF JASPER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 07/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1280 SUMMIT DR.
JASPER AL
35501-0102
US

IV. Provider business mailing address

1280 SUMMIT DR.
JASPER AL
35501-0102
US

V. Phone/Fax

Practice location:
  • Phone: 205-387-7555
  • Fax: 205-387-7551
Mailing address:
  • Phone: 205-387-7555
  • Fax: 205-387-7551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAN H WESTERMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 205-387-7555