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General NPI Number Information
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NPI Number | 1437384732
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Entity Type | Organization
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Legal Business Name | TRI-CITY NEUROLOGY
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Dates
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Enumeration Date | 05/16/2009
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Last Update Date | 05/16/2009
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Provider Practice Location Address
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Address Line | 200 BATTLE ST E
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City | TALLADEGA
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State | AL
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Zip | 35160-2420
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Country | US
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Telephone | 256-493-0349
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Fax |
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Provider Business Mailing Address
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Address Line | 200 BATTLE ST E
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City | TALLADEGA
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State | AL
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Zip | 35160-2420
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. FAZAL RAHIM
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Credential | MD
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Telephone | 256-493-0349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 25571
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License Number State | AL
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