Provider Demographics
NPI:1114910205
Name:ALABAMA INTERNAL MEDICINE, LLC
Entity Type:Organization
Organization Name:ALABAMA INTERNAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE CLERK
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DURROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-349-1606
Mailing Address - Street 1:1435 2ND CT E
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-3276
Mailing Address - Country:US
Mailing Address - Phone:205-349-1606
Mailing Address - Fax:205-349-3263
Practice Address - Street 1:1435 2ND CT E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-3276
Practice Address - Country:US
Practice Address - Phone:205-349-1606
Practice Address - Fax:205-349-3263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21385207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty