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NPI 1861377970

NPI 1861377970 : WEST ALABAMA PHYSICIAN ASSOCIATES, LLC : TUSCALOOSA, AL

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General NPI Number Information
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    NPI Number           |    1861377970
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    Entity Type          |    Organization 
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    Legal Business Name  |    WEST ALABAMA PHYSICIAN ASSOCIATES, LLC 
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Dates
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    Enumeration Date     |    08/07/2025
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    Last Update Date     |    09/02/2025
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Provider Practice Location Address
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    Address Line         |    1781 COMMONS NORTH LOOP 
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    City                 |    TUSCALOOSA
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    State                |    AL
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    Zip                  |    35406-3577
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    Country              |    US
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    Telephone            |    205-750-0447
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1781 COMMONS NORTH LOOP 
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    City                 |    TUSCALOOSA
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    State                |    AL
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    Zip                  |    35406-3577
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    VICE PRESIDENT, PHYSICIAN SERVICES
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    Name                 |     DANIEL CLAY CONVILLE 
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    Credential           |    
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    Telephone            |    205-759-6165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207XS0117X
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    Taxonomy Name        |    Orthopaedic Surgery of the Spine Physician
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    License Number       |    
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    License Number State |    
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