1619240710 NPI number — ALAN BILLSBY, DO

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619240710 NPI number — ALAN BILLSBY, DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALAN BILLSBY, DO
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:
1619240710
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 895
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHEFFIELD
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35660-0895
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-386-0558
Provider Business Mailing Address Fax Number:
256-314-6718

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1106 N CAVE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUSCUMBIA
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35674-1358
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-386-0558
Provider Business Practice Location Address Fax Number:
256-314-6718
Provider Enumeration Date:
02/21/2012

Additional Information

Authorized Official

Authorized Official Last Name:
LEONARD
Authorized Official First Name:
CAROLYN
Authorized Official Middle Name:
Authorized Official Title or Position:
CONTROLLER
Authorized Official Telephone Number:
256-386-4673

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  1239 , 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)





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