1235193053 NPI number — NORTH ALABAMA NEUROLOGICAL P. A.

Table of content: DR. DIRK MATTHEW DULMES D.C. (NPI 1508890716)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235193053 NPI number — NORTH ALABAMA NEUROLOGICAL P. A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH ALABAMA NEUROLOGICAL P. A.
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:
6
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:
1235193053
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/22/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
201 GOVERNORS DRIVE 1ST FLOOR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTSVILLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35801-4317
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-533-1600
Provider Business Mailing Address Fax Number:
256-539-0856

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 GOVERNORS DRIVE 1ST FLOOR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTSVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35801-4317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-533-1600
Provider Business Practice Location Address Fax Number:
256-539-0856
Provider Enumeration Date:
04/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PICKETT
Authorized Official First Name:
JOEL
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
256-533-1600

Provider Taxonomy Codes

  • Taxonomy code: 208100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: C076 . This is a "BCBS GROUP NUMBER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 000060076 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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