Provider Demographics
NPI:1346341948
Name:MCANALLEY, JERREL BRAD (MD)
Entity Type:Individual
Prefix:DR
First Name:JERREL
Middle Name:BRAD
Last Name:MCANALLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1120 S JACKSON HWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-5777
Mailing Address - Country:US
Mailing Address - Phone:256-383-4447
Mailing Address - Fax:256-381-7999
Practice Address - Street 1:1120 S JACKSON HWY
Practice Address - Street 2:SUITE 300
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-5777
Practice Address - Country:US
Practice Address - Phone:256-383-4447
Practice Address - Fax:256-381-7999
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL13555207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000028347Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
ALC73706Medicare UPIN