Basic Information
Provider Information
NPI: 1982659512
EntityType: 2
ReplacementNPI:  
OrganizationName: ALABAMA INPATIENT MEDICINE ASSOCIATES , LLC
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Mailing Information
Address1: PO BOX 52007
Address2:  
City: ATLANTA
State: GA
PostalCode: 303550007
CountryCode: US
TelephoneNumber: 6783970060
FaxNumber: 6783970065
Practice Location
Address1: 1108 ROSS CLARK CIR
Address2:  
City: DOTHAN
State: AL
PostalCode: 363013022
CountryCode: US
TelephoneNumber: 3347123635
FaxNumber: 3346994387
Other Information
ProviderEnumerationDate: 05/23/2006
LastUpdateDate: 08/22/2020
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AuthorizedOfficialLastName: YOUNG
AuthorizedOfficialFirstName: ROBERT
AuthorizedOfficialMiddleName: W
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 6783970060
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: MD
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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