Provider Demographics
NPI:1972994473
Name:ALABAMA VEIN SPECIALISTS GROUP LLC
Entity type:Organization
Organization Name:ALABAMA VEIN SPECIALISTS GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:205-823-0151
Mailing Address - Street 1:4721 CHACE CIR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3700
Mailing Address - Country:US
Mailing Address - Phone:205-823-0151
Mailing Address - Fax:205-823-5218
Practice Address - Street 1:4721 CHACE CIR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-3700
Practice Address - Country:US
Practice Address - Phone:205-823-0151
Practice Address - Fax:205-823-5218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-05
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27512208200000X
208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty