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General NPI Number Information
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NPI Number | 1316912934
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Entity Type | Organization
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Legal Business Name | OBSTETRICS AND GYNECOLOGY OF WEST ALABAMA PC
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Dates
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Enumeration Date | 02/17/2006
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Last Update Date | 08/08/2011
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Provider Practice Location Address
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Address Line | 2750 HOSPITAL DR
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City | NORTHPORT
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State | AL
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Zip | 35476-3360
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Country | US
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Telephone | 205-339-3039
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Fax | 205-339-9908
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Provider Business Mailing Address
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Address Line | 2750 HOSPITAL DR
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City | NORTHPORT
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State | AL
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Zip | 35476-3360
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Country | US
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Telephone | 205-339-3039
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Fax | 205-339-9908
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Authorized Official
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Title or Position | EMPLOYER
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Name | STEPHEN E ALLEN
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Credential | M.D.
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Telephone | 205-339-3039
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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 | 17027
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License Number State | AL
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