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General NPI Number Information
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NPI Number | 1861958340
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Entity Type | Organization
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Legal Business Name | CNOP LLC
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Dates
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Enumeration Date | 02/20/2019
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Last Update Date | 02/20/2019
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Provider Practice Location Address
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Address Line | 701 UNIVERSITY BLVD E STE 204
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City | TUSCALOOSA
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State | AL
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Zip | 35401-7431
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Country | US
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Telephone | 205-553-9171
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Fax | 205-553-9127
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Provider Business Mailing Address
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Address Line | 701 UNIVERSITY BLVD E STE 204
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City | TUSCALOOSA
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State | AL
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Zip | 35401-7431
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Country | US
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Telephone | 205-553-9171
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Fax | 205-553-9127
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. TIMOTHY PRESTLEY
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Credential | MD
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Telephone | 205-553-9171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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