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General NPI Number Information
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NPI Number | 1114330008
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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 | 06/09/2014
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 701 UNIVERSITY BLVD E SUITE 604
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City | TUSCALOOSA
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State | AL
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Zip | 35401-2086
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Country | US
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Telephone | 205-759-6925
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Fax | 205-759-6926
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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 | 205-333-4661
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Fax | 205-333-4660
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Authorized Official
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Title or Position | MEMBER REPRESENTATIVE
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Name | MR. DANIEL 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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number |
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License Number State |
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