Provider Demographics
NPI: | 1063744068 |
---|---|
Name: | HEALTHCARE ON DEMAND, PC |
Entity type: | Organization |
Organization Name: | HEALTHCARE ON DEMAND, PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RICHARD |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | STEHL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 334-558-0908 |
Mailing Address - Street 1: | PO BOX 242522 |
Mailing Address - Street 2: | |
Mailing Address - City: | MONTGOMERY |
Mailing Address - State: | AL |
Mailing Address - Zip Code: | 36124 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 334-558-0908 |
Mailing Address - Fax: | 334-558-0910 |
Practice Address - Street 1: | 4135 ATLANTA HIGHWAY |
Practice Address - Street 2: | |
Practice Address - City: | MONTGOMERY |
Practice Address - State: | AL |
Practice Address - Zip Code: | 36109 |
Practice Address - Country: | US |
Practice Address - Phone: | 334-558-0908 |
Practice Address - Fax: | 334-558-0910 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-02-02 |
Last Update Date: | 2010-02-02 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
AL | 27593 | 208D00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Single Specialty |