Provider Demographics
NPI:1558404947
Name:H. ANTHONY DRAKE, MD, PC
Entity Type:Organization
Organization Name:H. ANTHONY DRAKE, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOLSEY
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-870-4343
Mailing Address - Street 1:2018 BROOKWOOD MEDICAL CTR DR
Mailing Address - Street 2:POB 301
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6898
Mailing Address - Country:US
Mailing Address - Phone:205-870-4343
Mailing Address - Fax:205-870-0299
Practice Address - Street 1:2018 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:POB 301
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6898
Practice Address - Country:US
Practice Address - Phone:205-870-4343
Practice Address - Fax:205-870-0299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25443207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1326016494OtherINIDIVIDUAL NP