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General NPI Number Information
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NPI Number | 1831555218
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Entity Type | Organization
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Legal Business Name | RETNA A BILLANO LLC
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Dates
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Enumeration Date | 01/14/2016
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 4325 DOLLY RIDGE ROAD
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City | BIRMINGHAM
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State | AL
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Zip | 35243-5701
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Country | US
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Telephone | 205-591-2169
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Fax | 205-591-0815
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Provider Business Mailing Address
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Address Line | 4325 DOLLY RIDGE ROAD
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City | BIRMINGHAM
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State | AL
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Zip | 35243-5701
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Country | US
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Telephone | 205-591-2169
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Fax | 205-591-0815
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. RETNA A BILLANO
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Credential | M.D.
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Telephone | 205-591-2169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 16012301
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License Number State | AL
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