Provider Demographics
NPI:1033637434
Name:WEST ALABAMA AIDS OUTREACH
Entity Type:Organization
Organization Name:WEST ALABAMA AIDS OUTREACH
Other - Org Name:FIVE HORIZONS HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:KIRKPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:205-759-8470
Mailing Address - Street 1:2720 6TH ST
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-1731
Mailing Address - Country:US
Mailing Address - Phone:205-759-8470
Mailing Address - Fax:205-366-9001
Practice Address - Street 1:2720 6TH ST
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401
Practice Address - Country:US
Practice Address - Phone:205-759-8470
Practice Address - Fax:205-366-9001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty