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General NPI Number Information
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NPI Number | 1639391162
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Entity Type | Organization
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Legal Business Name | GADSDEN PULMONARY & SLEEP CLINIC, PC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 05/27/2015
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Provider Practice Location Address
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Address Line | 311 S 4TH ST
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City | GADSDEN
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State | AL
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Zip | 35901-5212
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Country | US
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Telephone | 256-547-4443
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Fax | 256-547-4476
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Provider Business Mailing Address
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Address Line | 311 S 4TH ST
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City | GADSDEN
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State | AL
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Zip | 35901-5212
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Country | US
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Telephone | 256-547-4443
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Fax | 256-547-4476
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Authorized Official
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Title or Position | ADM. ASST.
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Name | MRS. KRISTA J AUTWELL
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Credential |
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Telephone | 256-547-4443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 00017313
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 00017313
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 00017313
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License Number State | AL
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