Healthcare Provider Details

I. General information

NPI: 1780980540
Provider Name (Legal Business Name): ALABAMA BONE & JOINT CLINIC,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2011
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 CAHABA VALLEY PKWY STE 100
PELHAM AL
35124-1187
US

IV. Provider business mailing address

120 CAHABA VALLEY PKWY STE 100
PELHAM AL
35124-1187
US

V. Phone/Fax

Practice location:
  • Phone: 205-621-3778
  • Fax:
Mailing address:
  • Phone: 205-621-3778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number27369
License Number StateAL

VIII. Authorized Official

Name: DR. CHAD EVERETT MATHIS
Title or Position: DELEGATED OFFICIAL
Credential:
Phone: 205-621-3778