Provider Demographics
NPI:1578539441
Name:CARDIOVASCULAR ASSOCIATES OF NORTH ALABAMA, P.C.
Entity Type:Organization
Organization Name:CARDIOVASCULAR ASSOCIATES OF NORTH 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:L
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:205-599-3524
Mailing Address - Fax:205-599-3569
Practice Address - Street 1:209 W SPRING ST
Practice Address - Street 2:SUITE 104
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2973
Practice Address - Country:US
Practice Address - Phone:256-245-5833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL=========OtherTAX ID
ALI973Medicare ID - Type UnspecifiedBROOKWOOD-WOMENS
ALJ098Medicare ID - Type UnspecifiedTALLADEGA
AL=========OtherTAX ID
ALH478Medicare ID - Type UnspecifiedPELL CITY
ALC026Medicare ID - Type Unspecified
ALG696Medicare ID - Type UnspecifiedSYLACAUGA
ALE625Medicare ID - Type UnspecifiedBROOKWOOD