Provider Demographics
NPI:1033112198
Name:SEGAL, ALAN I (MS)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:I
Last Name:SEGAL
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9700 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-2827
Mailing Address - Country:US
Mailing Address - Phone:678-461-8039
Mailing Address - Fax:
Practice Address - Street 1:960 JOHNSON FERRY RD NE
Practice Address - Street 2:STE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1631
Practice Address - Country:US
Practice Address - Phone:404-943-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0843231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist