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General NPI Number Information
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NPI Number | 1225197197
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Entity Type | Organization
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Legal Business Name | WEST ALABAMA NEPHROLOGY, PC
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 05/13/2015
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Provider Practice Location Address
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Address Line | 4400 WATERMELON RD SUITE B
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City | NORTHPORT
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State | AL
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Zip | 35473-5204
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Country | US
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Telephone | 205-345-6302
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Fax | 205-247-4300
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Provider Business Mailing Address
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Address Line | 4400 WATERMELON RD SUITE B
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City | NORTHPORT
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State | AL
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Zip | 35473-5204
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Country | US
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Telephone | 205-345-6302
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Fax | 205-247-4300
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEOFFREY N ALILONU
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Credential | M.D.
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Telephone | 205-345-6302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 9748
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License Number State | AL
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