Provider Demographics
NPI:1437279601
Name:NORTH ALABAMA ENT ASSOCIATES
Entity Type:Organization
Organization Name:NORTH ALABAMA ENT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST/BOOKKEEPER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CORSAIR
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:256-536-9300
Mailing Address - Street 1:1963 MEMORIAL PARKWAY SW
Mailing Address - Street 2:SUITE 5 & 9
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801
Mailing Address - Country:US
Mailing Address - Phone:256-536-9300
Mailing Address - Fax:256-535-9032
Practice Address - Street 1:1963 MEMORIAL PARKWAY SW
Practice Address - Street 2:SUITE 5 & 9
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-536-9300
Practice Address - Fax:256-535-9032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529703900Medicaid
AL529704220Medicaid
174148900OtherUS DEPT OF LABOR
AL529703900Medicaid