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General NPI Number Information
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NPI Number | 1720034754
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Entity Type | Organization
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Legal Business Name | BRIDGER PATHOLOGY LABORATORIES INC. P.A.
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2055 NORMANDIE DR SUITE 208
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City | MONTGOMERY
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State | AL
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Zip | 36111-2732
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Country | US
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Telephone | 334-288-4963
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Fax | 334-288-4250
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Provider Business Mailing Address
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Address Line | 2055 NORMANDIE DR SUITE 208
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City | MONTGOMERY
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State | AL
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Zip | 36111-2732
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Country | US
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Telephone | 334-288-4963
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Fax | 334-288-4250
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM M BRIDGER
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Credential |
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Telephone | 334-288-4963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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