Provider Demographics
NPI:1518358241
Name:WELLCARE PSYCHIATRIC ASSOCIATES
Entity Type:Organization
Organization Name:WELLCARE PSYCHIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PADMAVATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:NATARAJ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-329-7805
Mailing Address - Street 1:2018 BROOKWOOD MEDICAL CTR DR
Mailing Address - Street 2:PROFESSIONAL OFFICE BUILDING, SUITE 311
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6898
Mailing Address - Country:US
Mailing Address - Phone:205-329-7805
Mailing Address - Fax:205-329-7806
Practice Address - Street 1:2018 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:PROFESSIONAL OFFICE BUILDING, SUITE 311
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6898
Practice Address - Country:US
Practice Address - Phone:205-329-7805
Practice Address - Fax:205-329-7806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty