Provider Demographics
NPI:1912966847
Name:NORTH ALABAMA OB-GYN ASSOCIATES, P.A.
Entity type:Organization
Organization Name:NORTH ALABAMA OB-GYN ASSOCIATES, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR/NP
Authorized Official - Prefix:
Authorized Official - First Name:BETHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RENFROW
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:912-674-4657
Mailing Address - Street 1:1041 BALCH RD STE 250
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8822
Mailing Address - Country:US
Mailing Address - Phone:256-704-2229
Mailing Address - Fax:256-704-2235
Practice Address - Street 1:1041 BALCH RD STE 250
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8822
Practice Address - Country:US
Practice Address - Phone:256-704-2229
Practice Address - Fax:256-704-2235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL207V00000X
207V00000X
AL14183207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529100940Medicaid
AL000087211Medicaid
ALD835Medicare UPIN
ALC75027Medicare UPIN
AL529100940Medicaid