Healthcare Provider Details

I. General information

NPI: 1558449991
Provider Name (Legal Business Name): ENT ASSOCIATES OF ALABAMA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 03/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1773 PLATT PL
MONTGOMERY AL
36117-7762
US

IV. Provider business mailing address

1773 PLATT PL
MONTGOMERY AL
36117-7762
US

V. Phone/Fax

Practice location:
  • Phone: 334-272-8644
  • Fax: 334-284-9714
Mailing address:
  • Phone: 334-272-8644
  • Fax: 334-284-9714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ALAN CRAIG CHAPMAN
Title or Position: OTOLARYNGOLOGIST
Credential: MD
Phone: 334-272-8644