Provider Demographics
NPI:1417511569
Name:DAVID L CASE MD LLC
Entity Type:Organization
Organization Name:DAVID L CASE MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CASE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-875-0411
Mailing Address - Street 1:69070 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:BLOUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35031
Mailing Address - Country:US
Mailing Address - Phone:205-875-0411
Mailing Address - Fax:
Practice Address - Street 1:69070 MAIN STREET
Practice Address - Street 2:
Practice Address - City:BLOUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35031
Practice Address - Country:US
Practice Address - Phone:205-875-0411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-24
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty