Provider Demographics
NPI:1457341638
Name:QUINN, PAMELA (MD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:QUINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7633 AL HIGHWAY 69
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-7137
Mailing Address - Country:US
Mailing Address - Phone:256-753-4345
Mailing Address - Fax:256-753-3010
Practice Address - Street 1:7633 AL HIGHWAY 69
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-7137
Practice Address - Country:US
Practice Address - Phone:256-753-4345
Practice Address - Fax:256-753-3010
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000217582084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000021152Medicaid
AL51021152OtherBCBS
AL51021152OtherBCBS
AL000021152Medicaid