Healthcare Provider Details

I. General information

NPI: 1427149731
Provider Name (Legal Business Name): ALABAMA SURGICAL CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4749 BERRY BLVD
MONTGOMERY AL
36106-3079
US

IV. Provider business mailing address

4749 BERRY BLVD
MONTGOMERY AL
36106-3079
US

V. Phone/Fax

Practice location:
  • Phone: 334-271-0280
  • Fax: 334-271-1918
Mailing address:
  • Phone: 334-271-0280
  • Fax: 334-271-1918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number00005301
License Number StateAL

VIII. Authorized Official

Name: HOWARD C SNIDER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 334-271-0280