1396884284 NPI number — MRS. OCIE DENISE MILNER RPT

Table of content: (NPI 1134275209)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396884284 NPI number — MRS. OCIE DENISE MILNER RPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILNER
Provider First Name:
OCIE
Provider Middle Name:
DENISE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STIGGERS
Provider Other First Name:
OCIE
Provider Other Middle Name:
DENISE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396884284
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
812 JEFFERY CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35235-2645
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-833-7464
Provider Business Mailing Address Fax Number:
205-833-7276

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
245 CAHABA VALLEY PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PELHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35124-2216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-942-6820
Provider Business Practice Location Address Fax Number:
205-942-5627
Provider Enumeration Date:
02/06/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PTH3776 , 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)