Provider Demographics
NPI:1386855930
Name:ALABAMA SURGICAL SPECIALISTS
Entity Type:Organization
Organization Name:ALABAMA SURGICAL SPECIALISTS
Other - Org Name:ORTHOPAEDIC SPORTS MEDICINE CLINIC OF ALABAMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:DARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:OT, CHT
Authorized Official - Phone:205-978-4969
Mailing Address - Street 1:200 MONTGOMERY HWY
Mailing Address - Street 2:SUITE 125
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1842
Mailing Address - Country:US
Mailing Address - Phone:205-978-4969
Mailing Address - Fax:205-978-4964
Practice Address - Street 1:200 MONTGOMERY HWY
Practice Address - Street 2:SUITE 125 AND SUITE 200
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-1842
Practice Address - Country:US
Practice Address - Phone:205-978-4969
Practice Address - Fax:205-978-4964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL526488001Medicare NSC