Provider Demographics
NPI:1194806836
Name:DR. VITKIN'S WEIGHT REDUCTION AND CONTROL CLINIC, P.C.
Entity type:Organization
Organization Name:DR. VITKIN'S WEIGHT REDUCTION AND CONTROL CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:EDMUND
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCGARITY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-442-1453
Mailing Address - Street 1:310 W GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906-3236
Mailing Address - Country:US
Mailing Address - Phone:256-442-1453
Mailing Address - Fax:256-442-1465
Practice Address - Street 1:1405 RAINBOW DR
Practice Address - Street 2:SUITE A
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5319
Practice Address - Country:US
Practice Address - Phone:256-549-1530
Practice Address - Fax:256-549-1530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9982261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center