Provider Demographics
NPI:1386626083
Name:PATHOLOGY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:PATHOLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-533-1480
Mailing Address - Street 1:2904 WESTCORP BLVD SW
Mailing Address - Street 2:SUITE 108
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35805-6437
Mailing Address - Country:US
Mailing Address - Phone:256-533-1480
Mailing Address - Fax:
Practice Address - Street 1:2904 WESTCORP BLVD SW
Practice Address - Street 2:SUITE 107/108
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-6437
Practice Address - Country:US
Practice Address - Phone:256-533-1480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-17
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207ZC0500X, 207ZD0900X, 207ZP0102X
ALL4506291U00000X
ALL4545291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathologyGroup - Single Specialty
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathologyGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51054163OtherBCBS
ALC500OtherBCBS
AL529502210Medicaid
AL530700103Medicaid
ALC500Medicare ID - Type Unspecified
AL529502210Medicaid