Provider Demographics
NPI:1497964118
Name:ALABAMA CARDIOVASCULAR SPECIALISTS
Entity Type:Organization
Organization Name:ALABAMA CARDIOVASCULAR SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:O
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:205-620-4867
Mailing Address - Street 1:606 1ST ST N
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-8769
Mailing Address - Country:US
Mailing Address - Phone:205-620-4867
Mailing Address - Fax:205-620-4864
Practice Address - Street 1:606 1ST ST N
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8769
Practice Address - Country:US
Practice Address - Phone:205-620-4867
Practice Address - Fax:205-620-4564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL304711174400000X, 302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No302F00000XManaged Care OrganizationsExclusive Provider OrganizationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALE852Medicare PIN
ALC71752Medicare UPIN