Provider Demographics
NPI:1265015291
Name:REPRODUCTIVE SURGERY CENTER OF HUNTSVILLE
Entity Type:Organization
Organization Name:REPRODUCTIVE SURGERY CENTER OF HUNTSVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRETT
Authorized Official - Last Name:DAVENPORT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-217-9613
Mailing Address - Street 1:808 TURNER ST SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5115
Mailing Address - Country:US
Mailing Address - Phone:256-217-9613
Mailing Address - Fax:
Practice Address - Street 1:808 TURNER ST SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5115
Practice Address - Country:US
Practice Address - Phone:256-217-9613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical