Provider Demographics
NPI:1558015453
Name:DR. PRAMOD BHATIA LLC
Entity Type:Organization
Organization Name:DR. PRAMOD BHATIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:PRAMOD
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-761-1729
Mailing Address - Street 1:PO BOX 622
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-0622
Mailing Address - Country:US
Mailing Address - Phone:205-694-2019
Mailing Address - Fax:205-631-8292
Practice Address - Street 1:204 MEDICAL PARK OFC PARK
Practice Address - Street 2:
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160-2213
Practice Address - Country:US
Practice Address - Phone:256-761-1729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Single Specialty