MEDICARE: JAMES ALAN AULTMAN D.M.D.. M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	6085	AL

General Provider Information

NPI Number	:	1891129540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES ALAN AULTMAN D.M.D.. M.S.

Provider Business Mailing Address
First Line	:	100 57TH ST S
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35212-2541
Country	:	US
Telephone Number	:	205-591-1101
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 57TH ST S
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35212-2541
Country	:	US
Telephone Number	:	205-591-1101
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2013
Last Update Date	:	09/09/2014

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