Provider Demographics
NPI:1245224294
Name:CAHABA PATHOLOGY
Entity Type:Organization
Organization Name:CAHABA PATHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-620-3329
Mailing Address - Street 1:PO BOX 11407
Mailing Address - Street 2:DRAWER 1238
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-0100
Mailing Address - Country:US
Mailing Address - Phone:800-897-6169
Mailing Address - Fax:800-897-6170
Practice Address - Street 1:644 2ND ST NE
Practice Address - Street 2:SUITE 2
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8824
Practice Address - Country:US
Practice Address - Phone:205-620-3329
Practice Address - Fax:205-664-4322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALF883OtherGROUP # BCBS OF AL
ALF883OtherGROUP # BCBS OF AL