Basic Information
| Provider Information | |||||||||
| NPI: | 1033267471 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ALABAMA ORTHOPAEDIC SPECIALISTS, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 235003 | ||||||||
| Address2: | |||||||||
| City: | MONTGOMERY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 361235003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3342749000 | ||||||||
| FaxNumber: | 3342740857 | ||||||||
| Practice Location | |||||||||
| Address1: | 4294 LOMAC ST | ||||||||
| Address2: | |||||||||
| City: | MONTGOMERY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 361063604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3342749000 | ||||||||
| FaxNumber: | 3342740857 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2007 | ||||||||
| LastUpdateDate: | 05/11/2020 | ||||||||
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| AuthorizedOfficialLastName: | O'NEAL | ||||||||
| AuthorizedOfficialFirstName: | RONALD | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 3342749116 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MPH, FACHE | ||||||||
| NPICertificationDate: | 05/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 1619954153 | 01 | PROVIDER NPI | OTHER |