Provider Demographics
NPI:1215057492
Name:NORTH ALABAMA ENT ASSOCIATES, P.C.
Entity type:Organization
Organization Name:NORTH ALABAMA ENT ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HERMAN
Authorized Official - Middle Name:MCKINLEY
Authorized Official - Last Name:TEACHEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-536-9300
Mailing Address - Street 1:PO BOX 18066
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-8066
Mailing Address - Country:US
Mailing Address - Phone:256-536-9300
Mailing Address - Fax:256-535-9032
Practice Address - Street 1:8337 HIGHWAY 72 W
Practice Address - Street 2:SUITE 301
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9547
Practice Address - Country:US
Practice Address - Phone:256-772-1884
Practice Address - Fax:256-772-1886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529704220Medicaid
AL529703900Medicaid
AL529704220Medicaid