Provider Demographics
NPI:1417929357
Name:NORTH ALABAMA FAMILY PRACTICE, PC
Entity Type:Organization
Organization Name:NORTH ALABAMA FAMILY PRACTICE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:REILAND
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:256-538-7273
Mailing Address - Street 1:515 3RD ST NW
Mailing Address - Street 2:
Mailing Address - City:ATTALLA
Mailing Address - State:AL
Mailing Address - Zip Code:35954-2022
Mailing Address - Country:US
Mailing Address - Phone:256-538-7273
Mailing Address - Fax:256-538-2514
Practice Address - Street 1:515 3RD ST NW
Practice Address - Street 2:
Practice Address - City:ATTALLA
Practice Address - State:AL
Practice Address - Zip Code:35954-2022
Practice Address - Country:US
Practice Address - Phone:256-538-7273
Practice Address - Fax:256-538-2514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL=========OtherTAX ID NUMBER