Provider Demographics
NPI:1154371839
Name:AMBULATORY ANESTHESIA & PAIN MEDICINE, P.C.
Entity type:Organization
Organization Name:AMBULATORY ANESTHESIA & PAIN MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-322-3332
Mailing Address - Street 1:1034 23RD ST S
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2481
Mailing Address - Country:US
Mailing Address - Phone:205-322-3332
Mailing Address - Fax:205-322-1305
Practice Address - Street 1:2621 19TH ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-1913
Practice Address - Country:US
Practice Address - Phone:205-271-8205
Practice Address - Fax:205-271-8332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALK839Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER