Healthcare Provider Details

I. General information

NPI: 1376509802
Provider Name (Legal Business Name): JOSEPH P MONLEY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PEPPERELL PKWY
OPELIKA AL
36801-5452
US

IV. Provider business mailing address

229 ASHFORD CIRCLE
LAGRANGE GA
30240
US

V. Phone/Fax

Practice location:
  • Phone: 334-528-1112
  • Fax: 334-528-1547
Mailing address:
  • Phone: 334-528-1112
  • Fax: 334-528-1547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License NumberDO-201
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: