Provider Demographics
NPI:1134303241
Name:ALABAMA ORTHOPAEDIC SPECIALISTS, P.A.
Entity Type:Organization
Organization Name:ALABAMA ORTHOPAEDIC SPECIALISTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:O'NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, FACHE
Authorized Official - Phone:334-274-9116
Mailing Address - Street 1:PO BOX 235003
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36123-5003
Mailing Address - Country:US
Mailing Address - Phone:334-274-9000
Mailing Address - Fax:334-274-0857
Practice Address - Street 1:277 HUNTRESS ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36092-5504
Practice Address - Country:US
Practice Address - Phone:334-274-9000
Practice Address - Fax:334-274-0857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0639390005Medicare NSC