Provider Demographics
NPI:1558580597
Name:CARDIOVASCULAR ASSOCIATES OF N. ALABAMA, P.C.
Entity Type:Organization
Organization Name:CARDIOVASCULAR ASSOCIATES OF N. ALABAMA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL STAFF AFFAIRS COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-599-3524
Mailing Address - Street 1:1280 COLUMBIANA RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1642
Mailing Address - Country:US
Mailing Address - Phone:205-599-3525
Mailing Address - Fax:205-599-3569
Practice Address - Street 1:800 MONTCLAIR RD
Practice Address - Street 2:9TH FLOOR
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1908
Practice Address - Country:US
Practice Address - Phone:205-599-4617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL=========OtherTAX ID #
AL=========OtherTAX ID #