Provider Demographics
NPI:1396843207
Name:LOWER ALABAMA RADIOLOGY
Entity Type:Organization
Organization Name:LOWER ALABAMA RADIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ARCEMENT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-368-6379
Mailing Address - Street 1:PO BOX 91341
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36691-1341
Mailing Address - Country:US
Mailing Address - Phone:251-460-0326
Mailing Address - Fax:
Practice Address - Street 1:401 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:ATMORE
Practice Address - State:AL
Practice Address - Zip Code:36502-3006
Practice Address - Country:US
Practice Address - Phone:251-460-0326
Practice Address - Fax:251-460-2846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC76017Medicare UPIN
ALG664Medicare PIN
AL000038163Medicare PIN