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General NPI Number Information
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NPI Number | 1629346820
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Entity Type | Organization
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Legal Business Name | REGIONAL MEDICAL CENTER BOARD
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Dates
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Enumeration Date | 12/02/2011
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 622 LEIGHTON AVE
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City | ANNISTON
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State | AL
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Zip | 36207-5744
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Country | US
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Telephone | 256-237-6717
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Fax | 256-236-1920
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Provider Business Mailing Address
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Address Line | 622 LEIGHTON AVE
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City | ANNISTON
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State | AL
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Zip | 36207-5744
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Country | US
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Telephone | 256-237-6717
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Fax | 256-236-1920
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ROBIN ADAMS
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Credential |
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Telephone | 256-237-6717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 21107
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License Number State | AL
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