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NPI 1942043070

NPI 1942043070 : WEST ALABAMA AIDS OUTREACH INC : TUSCALOOSA, AL

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General NPI Number Information
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    NPI Number           |    1942043070
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    Entity Type          |    Organization 
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    Legal Business Name  |    WEST ALABAMA AIDS OUTREACH INC 
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Dates
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    Enumeration Date     |    06/17/2024
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    Last Update Date     |    01/09/2026
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Provider Practice Location Address
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    Address Line         |    2703 7TH ST 
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    City                 |    TUSCALOOSA
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    State                |    AL
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    Zip                  |    35401-1865
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    Country              |    US
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    Telephone            |    205-759-8470
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    Fax                  |    205-366-9001
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Provider Business Mailing Address
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    Address Line         |    2715 7TH ST 
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    City                 |    TUSCALOOSA
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    State                |    AL
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    Zip                  |    35401-1805
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    Country              |    US
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    Telephone            |    205-759-8470
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    Fax                  |    205-366-9001
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     BILLY DANIEL KIRKPATRICK 
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    Credential           |    
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    Telephone            |    205-759-8470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208D00000X
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    Taxonomy Name        |    General Practice Physician
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    207RI0200X
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    Taxonomy Name        |    Infectious Disease Physician
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    License Number       |    
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    License Number State |    
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