Healthcare Provider Details

I. General information

NPI: 1437384732
Provider Name (Legal Business Name): TRI-CITY NEUROLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2009
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4402 COGSWELL AVE
PELL CITY AL
35125-2702
US

IV. Provider business mailing address

4402 COGSWELL AVE
PELL CITY AL
35125-2702
US

V. Phone/Fax

Practice location:
  • Phone: 256-362-9677
  • Fax: 256-362-9676
Mailing address:
  • Phone: 256-362-9677
  • Fax: 256-362-9676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number25571
License Number StateAL

VIII. Authorized Official

Name: DR. FAZAL RAHIM
Title or Position: OWNER
Credential: MD
Phone: 256-493-0349