Provider Demographics
NPI:1396035101
Name:EAST ALABAMA ALLERGY AND ASTHMA, PLLC
Entity Type:Organization
Organization Name:EAST ALABAMA ALLERGY AND ASTHMA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:TOLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:334-528-0078
Mailing Address - Street 1:1925 E GLENN AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-5729
Mailing Address - Country:US
Mailing Address - Phone:334-528-0078
Mailing Address - Fax:334-528-0079
Practice Address - Street 1:1925 E GLENN AVE STE 101
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-5729
Practice Address - Country:US
Practice Address - Phone:334-528-0078
Practice Address - Fax:334-528-0079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO.1138261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty