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General NPI Number Information
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NPI Number | 1790955920
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Entity Type | Organization
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Legal Business Name | AVALON SURGICAL,P.C.
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Dates
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Enumeration Date | 03/04/2008
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Last Update Date | 07/16/2013
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Provider Practice Location Address
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Address Line | 1120 S JACKSON HWY STE 307
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City | SHEFFIELD
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State | AL
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Zip | 35660-5773
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Country | US
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Telephone | 256-381-0030
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Fax | 256-383-0764
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Provider Business Mailing Address
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Address Line | PO BOX 298
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City | SHEFFIELD
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State | AL
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Zip | 35660-0298
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Country | US
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Telephone | 256-381-0030
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Fax | 256-383-0764
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID PARKS MCKINLEY
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Credential | M.D.,
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Telephone | 256-381-0030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 5762
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License Number State | AL
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