Basic Information
| Provider Information | |||||||||
| NPI: | 1356505036 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANDREW G FINLAY, JR., M.D. PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 338 | ||||||||
| Address2: | |||||||||
| City: | ALBERTVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 359500006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565938114 | ||||||||
| FaxNumber: | 2565932679 | ||||||||
| Practice Location | |||||||||
| Address1: | 602B CORLEY AVE | ||||||||
| Address2: | |||||||||
| City: | BOAZ | ||||||||
| State: | AL | ||||||||
| PostalCode: | 359575952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565938114 | ||||||||
| FaxNumber: | 2565932679 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2008 | ||||||||
| LastUpdateDate: | 07/11/2008 | ||||||||
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| AuthorizedOfficialLastName: | FINLAY | ||||||||
| AuthorizedOfficialFirstName: | ANDREW | ||||||||
| AuthorizedOfficialMiddleName: | G | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2565938114 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 5334 | AL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000002066 | 05 | AL | MEDICAID |