1477639839 NPI number — RAPE & BROOKS ORTHODONTICS PC

Table of content: (NPI 1477639839)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477639839 NPI number — RAPE & BROOKS ORTHODONTICS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAPE & BROOKS ORTHODONTICS PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LUTHER T CALE AND W GREGORY RAPE, ORTHODONTISTS PC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477639839
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/30/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 327
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLAY
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35048-0327
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-680-4475
Provider Business Mailing Address Fax Number:
205-680-4476

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6840 MURRAY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PINSON
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35126-6018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-680-4475
Provider Business Practice Location Address Fax Number:
205-680-4476
Provider Enumeration Date:
10/28/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BROOKS
Authorized Official First Name:
TERRY
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
ORTHODONTIST PARTNER
Authorized Official Telephone Number:
205-680-4475

Provider Taxonomy Codes

  • Taxonomy code: 1223X0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)