Healthcare Provider Details

I. General information

NPI: 1437417086
Provider Name (Legal Business Name): CAPSTONE SURGICAL ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2012
Last Update Date: 05/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 UNIVERSITY BLVD E SUITE 602
TUSCALOOSA AL
35401-7406
US

IV. Provider business mailing address

701 UNIVERSITY BLVD E SUITE 602
TUSCALOOSA AL
35401-7406
US

V. Phone/Fax

Practice location:
  • Phone: 205-333-4655
  • Fax: 205-758-4201
Mailing address:
  • Phone: 205-333-4655
  • Fax: 205-758-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. QUINTON D MATTHEWS
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 205-333-4655