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General NPI Number Information
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NPI Number | 1326464975
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Entity Type | Individual
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Provider Name | MARY ALICE NOEL MD
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Gender | Female
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Dates
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Enumeration Date | 03/06/2014
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 200 BRULE ST
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City | FORT KNOX
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State | KY
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Zip | 40121-6100
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Country | US
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Telephone | 800-493-9602
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Fax |
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Provider Business Mailing Address
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Address Line | 6600 VAN AALST BLVD
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City | FORT MOORE
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State | GA
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Zip | 31905-2102
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Country | US
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Telephone | 762-408-2273
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Fax | 762-408-8103
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 70987
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License Number State | GA
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