Provider Demographics
NPI:1528387339
Name:NEUROLOGICAL INSTITUTE OF ALABAMA INC
Entity Type:Organization
Organization Name:NEUROLOGICAL INSTITUTE OF ALABAMA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:STIDHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-874-8888
Mailing Address - Street 1:509 BROOKWOOD BLVD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6801
Mailing Address - Country:US
Mailing Address - Phone:205-874-8888
Mailing Address - Fax:205-874-8880
Practice Address - Street 1:509 BROOKWOOD BLVD
Practice Address - Street 2:SUITE 121
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6801
Practice Address - Country:US
Practice Address - Phone:205-874-8888
Practice Address - Fax:205-874-8880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-19
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1528387339OtherNPI