Provider Demographics
NPI:1417923129
Name:CARDIOVASCULAR ASSOCIATES OF NORTH ALABAMA, PC
Entity Type:Organization
Organization Name:CARDIOVASCULAR ASSOCIATES OF NORTH ALABAMA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL STAFF AFFAIRS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-599-3524
Mailing Address - Street 1:1280 COLUMBIANA RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1642
Mailing Address - Country:US
Mailing Address - Phone:205-599-3540
Mailing Address - Fax:
Practice Address - Street 1:880 MONTCLAIR RD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1972
Practice Address - Country:US
Practice Address - Phone:205-599-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL=========OtherTAX ID
AL=========OtherTAX ID
ALG696Medicare ID - Type UnspecifiedSYLACAUGA
ALE625Medicare ID - Type UnspecifiedBROOKWOOD
ALJ098Medicare ID - Type UnspecifiedTALLADEGA
ALH325Medicare ID - Type UnspecifiedONEONTA-BLOUNT
ALH478Medicare ID - Type UnspecifiedPELL CITY
ALI973Medicare ID - Type UnspecifiedBROOKWOOD-WOMENS