1699840827 NPI number — LONNIE N. ALBIN, M.D., FAMILY MEDICINE, P.C.

Table of content: (NPI 1699840827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699840827 NPI number — LONNIE N. ALBIN, M.D., FAMILY MEDICINE, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LONNIE N. ALBIN, M.D., FAMILY MEDICINE, P.C.
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:
Provider Other Organization Name Type Code:
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:
1699840827
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
507 HARLEY STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCOTTSBORO
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35768
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-259-5550
Provider Business Mailing Address Fax Number:
259-256-5552

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
507 HARLEY STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCOTTSBORO
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35768
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-259-5550
Provider Business Practice Location Address Fax Number:
259-256-5552
Provider Enumeration Date:
11/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ALBIN
Authorized Official First Name:
LONNIE
Authorized Official Middle Name:
N
Authorized Official Title or Position:
PHYSICIAN/PRESIDENT
Authorized Official Telephone Number:
256-259-5550

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  20176 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 529918970 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 051517783 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com