Healthcare Provider Details

I. General information

NPI: 1922112754
Provider Name (Legal Business Name): JAY C STRICKLAND CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 02/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 GILBREATH DR
ONEONTA AL
35121-2827
US

IV. Provider business mailing address

8415 OLD HIGHWAY 31
MORRIS AL
35116-1232
US

V. Phone/Fax

Practice location:
  • Phone: 205-274-3278
  • Fax: 205-274-3276
Mailing address:
  • Phone: 205-647-6222
  • Fax: 205-647-7987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1056247
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: