Healthcare Provider Details

I. General information

NPI: 1336709187
Provider Name (Legal Business Name): ALEX JOSEPH MCCRORY PA-C, LAT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2019
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 PAUL W BRYANT DR E
TUSCALOOSA AL
35401-2055
US

IV. Provider business mailing address

305 PAUL W BRYANT DR E
TUSCALOOSA AL
35401-2055
US

V. Phone/Fax

Practice location:
  • Phone: 205-345-0192
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number2529
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.2375
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: