1063668515 NPI number — ALABAMA NEUROLOGY ASSOCIATES, PC

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 1063668515 NPI number — ALABAMA NEUROLOGY ASSOCIATES, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALABAMA NEUROLOGY ASSOCIATES, 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:
1063668515
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
509 BROOKWOOD BLVD
Provider Second Line Business Mailing Address:
STE # 101A
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35209
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-803-2210
Provider Business Mailing Address Fax Number:
205-803-2214

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
509 BROOKWOOD BLVD
Provider Second Line Business Practice Location Address:
STE # 101A
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35209-6801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-803-2210
Provider Business Practice Location Address Fax Number:
205-803-2214
Provider Enumeration Date:
08/15/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RISER
Authorized Official First Name:
EMILY
Authorized Official Middle Name:
S
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
205-803-2210

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  12140 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X , with the licence number: 12139 , 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: 51505043 . This is a "BCBS PROVIDER # DR JOHN RISER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51505028 . This is a "BCBS PROVIDER # DR. EMILY RISER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51505043 . This is a "MEDICARE PROVIDER NUMBER DR. JOHN RISER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51505028 . This is a "EMILY RISER MEDICARE PROVIDER #" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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