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General NPI Number Information
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NPI Number | 1871931808
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Entity Type | Organization
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Legal Business Name | OAK MOUNTAIN ONCOLOGY HEMATOLOGY ASSOCIATES LLC
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Dates
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Enumeration Date | 06/12/2013
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Last Update Date | 07/25/2013
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Provider Practice Location Address
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Address Line | 985 9TH AVE SW SUITE 404
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City | BESSEMER
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State | AL
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Zip | 35022-4500
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Country | US
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Telephone | 205-481-8475
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Fax | 205-481-8478
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Provider Business Mailing Address
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Address Line | PO BOX 383125
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City | BIRMINGHAM
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State | AL
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Zip | 35238-3125
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Country | US
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Telephone | 205-481-8475
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Fax | 205-481-8478
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Authorized Official
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Title or Position | OWNER
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Name | DR. JANE ANN GEHLSEN
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Credential | MD
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Telephone | 205-481-8475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 17581
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License Number State | AL
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