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General NPI Number Information
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NPI Number | 1760420384
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Entity Type | Organization
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Legal Business Name | WEST ALABAMA ORTHOPAEDIC AND SPORTS MEDICINE, PC
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 02/04/2009
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Provider Practice Location Address
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Address Line | 1325 MCFARLAND BLVD SUITE 102
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City | NORTHPORT
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State | AL
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Zip | 35476-3270
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Country | US
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Telephone | 205-333-8800
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Fax | 205-333-8406
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Provider Business Mailing Address
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Address Line | PO BOX 840
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City | NORTHPORT
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State | AL
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Zip | 35476-0840
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Country | US
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Telephone | 205-333-8800
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Fax | 205-333-8406
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Authorized Official
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Title or Position | INSURANCE SPECIALIST
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Name | MRS. KATHRYN BANKS PRITCHETT
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Credential |
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Telephone | 205-330-4206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 00022472
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | DO932
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 00009008
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License Number State | AL
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