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General NPI Number Information
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NPI Number | 1588803811
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Entity Type | Organization
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Legal Business Name | EAST ALABAMA ENDOCRINOLOGY, P.C.
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Dates
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Enumeration Date | 02/10/2009
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 3320 SKYWAY DR SUITE 808
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City | OPELIKA
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State | AL
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Zip | 36801-7137
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Country | US
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Telephone | 334-737-2737
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Fax | 334-821-1043
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Provider Business Mailing Address
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Address Line | 3320 SKYWAY DR STE 602
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City | OPELIKA
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State | AL
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Zip | 36801-7138
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Country | US
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Telephone | 334-737-2737
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Fax | 334-821-1043
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. LORI B FULLER
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Credential |
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Telephone | 334-737-2737
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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 | 27288
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License Number State | AL
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