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General NPI Number Information
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NPI Number | 1508907684
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Entity Type | Organization
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Legal Business Name | CHARLES F ALBERT
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 210 INDIAN SPRINGS DR
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City | FLORENCE
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State | AL
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Zip | 35634-2056
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Country | US
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Telephone | 256-810-3036
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Fax |
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Provider Business Mailing Address
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Address Line | 210 INDIAN SPRINGS DR
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City | FLORENCE
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State | AL
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Zip | 35634-2056
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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 | CHARLES ALBERT
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Credential | M.D.
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Telephone | 256-810-3036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-063128
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 15691
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License Number State | AL
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