Basic Information
| Provider Information | |||||||||
| NPI: | 1871992834 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FOCUSAL1010 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 360127 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352360127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8772253542 | ||||||||
| FaxNumber: | 8776389903 | ||||||||
| Practice Location | |||||||||
| Address1: | 3165 DAUPHIN ST | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366064061 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2513788635 | ||||||||
| FaxNumber: | 2513788636 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2014 | ||||||||
| LastUpdateDate: | 08/15/2014 | ||||||||
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| AuthorizedOfficialLastName: | FUHLER | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2513788635 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.