Healthcare Provider Details

I. General information

NPI: 1982998050
Provider Name (Legal Business Name): ANESTHESIA CARE OF ALABAMA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 06/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 RIVER CHASE DR
PHENIX CITY AL
36867-7483
US

IV. Provider business mailing address

PO BOX 5319
HIGH POINT NC
27262-5319
US

V. Phone/Fax

Practice location:
  • Phone: 334-732-3010
  • Fax: 334-732-3020
Mailing address:
  • Phone: 336-884-1830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number
License Number State

VIII. Authorized Official

Name: ALAN DALE HILLIARD
Title or Position: CFO
Credential:
Phone: 336-884-1830