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General NPI Number Information
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NPI Number | 1649280793
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Entity Type | Individual
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Provider Name | LOUIS CLARENCE REMYNSE III M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 1948 AL HIGHWAY 157 STE 230
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City | CULLMAN
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State | AL
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Zip | 35058-0642
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Country | US
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Telephone | 256-737-2177
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Fax | 256-203-8684
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Provider Business Mailing Address
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Address Line | PO BOX 2895
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City | CULLMAN
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State | AL
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Zip | 35056-2895
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Country | US
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Telephone | 256-737-2177
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Fax | 256-203-8684
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4301055819
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 042.0012584
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 080172
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License Number State | GA
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Legacy Identifiers
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Identifier #1
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Identifier Code | 036150216
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Identifier Type | OTHER
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Identifier State | IL
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Identifier Issuer | LICENSE
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Identifier #2
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Identifier Code | 1021499
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Identifier Type | MEDICAID
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Identifier State | VT
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Identifier Issuer |
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Identifier #3
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Identifier Code | VN3891
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Identifier Type | OTHER
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Identifier State | VT
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Identifier Issuer | CVMC-MEDICARE
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Identifier #4
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Identifier Code | 2750986
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Identifier Type | MEDICAID
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Identifier State | MI
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Identifier Issuer |
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Identifier #5
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Identifier Code | OVN3891
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Identifier Type | OTHER
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Identifier State | VT
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Identifier Issuer | CVMC-MEDICAID
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 036150216
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Identifier Type | OTHER
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Identifier State | IL
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Identifier Issuer | LICENSE
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Identifier #2
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Identifier Code | 1021499
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Identifier Type | MEDICAID
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Identifier State | VT
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Identifier Issuer |
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Identifier #3
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Identifier Code | 2750986
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Identifier Type | MEDICAID
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Identifier State | MI
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Identifier Issuer |
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Identifier #4
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Identifier Code | OVN3891
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Identifier Type | OTHER
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Identifier State | VT
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Identifier Issuer | CVMC-MEDICAID
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Identifier #5
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Identifier Code | VN3891
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Identifier Type | OTHER
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Identifier State | VT
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Identifier Issuer | CVMC-MEDICARE
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