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General NPI Number Information
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NPI Number | 1023421468
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Entity Type | Organization
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Legal Business Name | ALABAMA EAR, NOSE & THROAT SPECIALISTS, LLC
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 09/03/2014
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Provider Practice Location Address
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Address Line | 302 MERCHANTS WALK SUITE 100
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City | TUSCALOOSA
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State | AL
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Zip | 35406-2290
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Country | US
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Telephone | 205-523-9300
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Fax | 205-523-9301
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Provider Business Mailing Address
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Address Line | 302 MERCHANTS WALK SUITE 100
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City | TUSCALOOSA
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State | AL
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Zip | 35406-2290
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Country | US
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Telephone | 205-523-9300
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Fax | 205-523-9301
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Authorized Official
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Title or Position | PARTNER
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Name | CRAIG M BENOIT
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Credential | MD
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Telephone | 205-523-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | 26424
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 26424
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License Number State | AL
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