Provider Demographics
NPI:1588721773
Name:ALABAMA COLON & RECTAL INSTITUTE, P.C.
Entity type:Organization
Organization Name:ALABAMA COLON & RECTAL INSTITUTE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:COYLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:205-458-5000
Mailing Address - Street 1:1317 4TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1408
Mailing Address - Country:US
Mailing Address - Phone:205-458-5000
Mailing Address - Fax:205-458-5005
Practice Address - Street 1:1317 4TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1408
Practice Address - Country:US
Practice Address - Phone:205-458-5000
Practice Address - Fax:205-458-5005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALCE0105OtherRAILROAD MEDICARE