Basic Information
| Provider Information | |||||||||
| NPI: | 1659646040 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | APP OF ALABAMA ED PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12 CADILLAC DRIVE | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6159286264 | ||||||||
| FaxNumber: | 6157605985 | ||||||||
| Practice Location | |||||||||
| Address1: | 15155 HIGHWAY 43 | ||||||||
| Address2: | |||||||||
| City: | RUSSELLVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35653 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2563321611 | ||||||||
| FaxNumber: | 2563314338 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2012 | ||||||||
| LastUpdateDate: | 07/28/2017 | ||||||||
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| AuthorizedOfficialLastName: | SOMERBY | ||||||||
| AuthorizedOfficialFirstName: | CHARLES | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6159286264 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171W00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Other Service Providers | Contractor |
No ID Information.