Provider Demographics
NPI:1326612243
Name:ALABAMA ORTHOPAEDIC CLINIC, P.C.
Entity Type:Organization
Organization Name:ALABAMA ORTHOPAEDIC CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:PIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-410-3650
Mailing Address - Street 1:3610 SPRINGHILL MEMORIAL DR N
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1162
Mailing Address - Country:US
Mailing Address - Phone:251-410-3651
Mailing Address - Fax:251-410-3819
Practice Address - Street 1:75 SHELL STREET
Practice Address - Street 2:
Practice Address - City:SARALAND
Practice Address - State:AL
Practice Address - Zip Code:36571
Practice Address - Country:US
Practice Address - Phone:251-410-3600
Practice Address - Fax:251-410-3700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-15
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529603600Medicaid