Healthcare Provider Details

I. General information

NPI: 1215057492
Provider Name (Legal Business Name): NORTH ALABAMA ENT ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 12/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8337 HIGHWAY 72 W SUITE 301
MADISON AL
35758-9547
US

IV. Provider business mailing address

PO BOX 18066
HUNTSVILLE AL
35804-8066
US

V. Phone/Fax

Practice location:
  • Phone: 256-772-1884
  • Fax: 256-772-1886
Mailing address:
  • Phone: 256-536-9300
  • Fax: 256-535-9032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: HERMAN MCKINLEY TEACHEY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 256-536-9300