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General NPI Number Information
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NPI Number | 1104668417
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Entity Type | Organization
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Legal Business Name | WEST ALABAMA PHYSICIAN ASSOCIATES, LLC
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 701 UNIVERSITY BLVD E STE 204
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City | TUSCALOOSA
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State | AL
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Zip | 35401-7431
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Country | US
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Telephone | 205-343-8837
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 GREENSBORO AVE STE A
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City | TUSCALOOSA
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State | AL
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Zip | 35405-3771
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Country | US
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Telephone | 205-343-8837
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Fax |
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Authorized Official
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Title or Position | CORP DIRECTOR, PHYSICIAN SERVICES
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Name | DANIEL CLAY CONVILLE
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Credential |
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Telephone | 205-759-6165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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