1770687105 NPI number — DR. THOMAS AL SAUNDERS JR. PSYD

Table of content: DR. THOMAS AL SAUNDERS JR. PSYD (NPI 1770687105)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770687105 NPI number — DR. THOMAS AL SAUNDERS JR. PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAUNDERS
Provider First Name:
THOMAS
Provider Middle Name:
AL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
PSYD
Provider Gender Code:
M

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:
1770687105
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:
624 MILL SPRINGS COURT
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:
35244
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-408-2823
Provider Business Mailing Address Fax Number:
205-879-9962

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 OFFICE PARK DR
Provider Second Line Business Practice Location Address:
SUITE 325
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-879-9964
Provider Business Practice Location Address Fax Number:
205-879-9962
Provider Enumeration Date:
09/07/2006

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: 103TC0700X , with the licence number:  889 , 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: 51517795 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51099731 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51517698 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51045027 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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