1124126552 NPI number — DR. JAMES NABERS DO PC

Table of content: (NPI 1124126552)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124126552 NPI number — DR. JAMES NABERS DO PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. JAMES NABERS DO 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:
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:
1124126552
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
219 HOSPITAL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RED BAY
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35582-3858
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-356-9537
Provider Business Mailing Address Fax Number:
256-356-2315

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
219 HOSPITAL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RED BAY
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35582
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-356-9537
Provider Business Practice Location Address Fax Number:
256-356-2315
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NABERS
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
256-356-9537

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X , with the licence number:  DO252 , 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: 0122284 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 51527555 . This is a "RURAL HEALTH BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 541003938 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 51020601 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 000020601 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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