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General NPI Number Information
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NPI Number | 1912044512
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Entity Type | Organization
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Legal Business Name | ALABAMA ORTHOPEDIC CARE PC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 04/27/2009
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Provider Practice Location Address
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Address Line | 1018 S BRUNDIDGE ST SUITE C
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City | TROY
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State | AL
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Zip | 36081-3121
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Country | US
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Telephone | 334-566-8881
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Fax | 334-566-7785
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Provider Business Mailing Address
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Address Line | 1018 S BRUNDIDGE ST SUITE C
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City | TROY
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State | AL
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Zip | 36081-3121
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Country | US
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Telephone | 334-566-8881
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Fax | 334-566-7785
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DARRELL JACK POTTER
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Credential | MD
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Telephone | 334-566-8881
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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 | 21790
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License Number State | AL
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