Provider Demographics
NPI:1174688048
Name:SURGICAL SPECIALISTS OF ALABAMA, PC
Entity Type:Organization
Organization Name:SURGICAL SPECIALISTS OF ALABAMA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:FALGOUT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-345-2211
Mailing Address - Street 1:1031 FAIRFAX PARK
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2807
Mailing Address - Country:US
Mailing Address - Phone:205-345-2211
Mailing Address - Fax:205-345-2220
Practice Address - Street 1:1031 FAIRFAX PARK
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2807
Practice Address - Country:US
Practice Address - Phone:205-345-2211
Practice Address - Fax:205-345-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC78654Medicare UPIN
ALE867Medicare PIN
ALC71092Medicare UPIN
ALF44659Medicare UPIN
CI6082Medicare PIN
ALC70697Medicare UPIN
ALC70923Medicare UPIN
ALI 06635Medicare UPIN