Provider Demographics
NPI:1588378475
Name:WEST ALABAMA AIDS OUTREACH
Entity type:Organization
Organization Name:WEST ALABAMA AIDS OUTREACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:KIRKPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-759-8470
Mailing Address - Street 1:3052 MCGEHEE RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36111-2203
Mailing Address - Country:US
Mailing Address - Phone:334-280-3349
Mailing Address - Fax:
Practice Address - Street 1:3052 MCGEHEE RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36111-2203
Practice Address - Country:US
Practice Address - Phone:334-280-3349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty