Provider Demographics
NPI:1992973408
Name:ALABAMA ORTHOPAEDICS AND SPORTS MEDICINE ASSOC
Entity type:Organization
Organization Name:ALABAMA ORTHOPAEDICS AND SPORTS MEDICINE ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:HARKNESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-395-5800
Mailing Address - Street 1:242 WINTON M BLOUNT LOOP
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3501
Mailing Address - Country:US
Mailing Address - Phone:334-395-5800
Mailing Address - Fax:334-395-5880
Practice Address - Street 1:242 WINTON M BLOUNT LOOP
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3501
Practice Address - Country:US
Practice Address - Phone:334-395-5800
Practice Address - Fax:334-395-5880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00008637174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty