1356505036 NPI number — ANDREW G FINLAY, JR., M.D. PC

Table of content: (NPI 1356505036)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356505036 NPI number — ANDREW G FINLAY, JR., M.D. PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANDREW G FINLAY, JR., M.D. 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:
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:
1356505036
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 338
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALBERTVILLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35950-0006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-593-8114
Provider Business Mailing Address Fax Number:
256-593-2679

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
602B CORLEY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOAZ
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35957-5952
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-593-8114
Provider Business Practice Location Address Fax Number:
256-593-2679
Provider Enumeration Date:
07/11/2008

Additional Information

Authorized Official

Authorized Official Last Name:
FINLAY
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
G
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
256-593-8114

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  5334 , 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: 000002066 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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