1265536569 NPI number — EMILY DOLBARE FEELY MD

Table of content: EMILY DOLBARE FEELY MD (NPI 1265536569)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265536569 NPI number — EMILY DOLBARE FEELY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FEELY
Provider First Name:
EMILY
Provider Middle Name:
DOLBARE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DOLBARE
Provider Other First Name:
EMILY
Provider Other Middle Name:
LARAE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1265536569
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/05/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7399 RIDGECREST COURT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VESTAVIA
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35242-0519
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-226-5900
Provider Business Mailing Address Fax Number:
205-226-5937

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2700 RODGERS DRIVE
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
HOMEWOOD
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-226-5900
Provider Business Practice Location Address Fax Number:
205-226-5937
Provider Enumeration Date:
09/08/2006

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: 207R00000X , with the licence number:  060831 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RN0300X , with the licence number: 060831 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RN0300X , with the licence number: 200500033 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RN0300X , with the licence number: 34451 , 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: P00649788 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: N4608698 . This is a "WELLCARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 52238975 001 . This is a "BCBS - GA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 1225667 . This is a "AMERIGROUP" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: P00649788 . This is a "MEDICARE - RAILROAD" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".




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