Provider Demographics
NPI:1194183749
Name:NAAMAN CLINIC, LLC
Entity Type:Organization
Organization Name:NAAMAN CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:EVANS
Authorized Official - Middle Name:C
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-453-4195
Mailing Address - Street 1:100 CONCOURSE PKWY
Mailing Address - Street 2:STE 265
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1881
Mailing Address - Country:US
Mailing Address - Phone:205-453-4196
Mailing Address - Fax:205-533-7385
Practice Address - Street 1:100 CONCOURSE PKWY
Practice Address - Street 2:STE 265
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-1881
Practice Address - Country:US
Practice Address - Phone:205-453-4196
Practice Address - Fax:205-533-7385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26882207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1194183749OtherGROUP NPI