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General NPI Number Information
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NPI Number | 1629120712
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Entity Type | Organization
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Legal Business Name | EMERGENCY MEDICINE SOUTH
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2000 PEPPERELL PKWY
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City | OPELIKA
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State | AL
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Zip | 36801-5452
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Country | US
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Telephone | 334-528-1112
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Fax | 334-528-1114
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Provider Business Mailing Address
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Address Line | 2000 PEPPERELL PKWY
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City | OPELIKA
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State | AL
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Zip | 36801-5452
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Country | US
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Telephone | 334-528-1112
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Fax | 334-528-1114
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Authorized Official
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Title or Position | EMERGENCY MEDICINE PHYSICIAN
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Name | DR. ALAN L MOORE
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Credential | M.D.
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Telephone | 334-528-1112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number |
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License Number State |
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