Provider Demographics
NPI:1962896613
Name:DR. J. DONALD CARMICHAEL PA
Entity type:Organization
Organization Name:DR. J. DONALD CARMICHAEL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:CARMICHAEL
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:205-879-7849
Mailing Address - Street 1:2857 CANTERBURY RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-1201
Mailing Address - Country:US
Mailing Address - Phone:205-879-7849
Mailing Address - Fax:
Practice Address - Street 1:2857 CANTERBURY RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-1201
Practice Address - Country:US
Practice Address - Phone:205-879-7849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2962086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty