Provider Demographics
NPI:1629255278
Name:PRIMARY CARE ASSOCIATES OF NORTH ALABAMA, PC
Entity Type:Organization
Organization Name:PRIMARY CARE ASSOCIATES OF NORTH ALABAMA, PC
Other - Org Name:CHILDREN'S ASSOCIATES OF ATHENS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IQBAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MEMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-216-8863
Mailing Address - Street 1:P.O.BOX 922
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35612-0922
Mailing Address - Country:US
Mailing Address - Phone:256-216-8863
Mailing Address - Fax:256-216-5563
Practice Address - Street 1:108 SANDERS ST
Practice Address - Street 2:SUITE B
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2459
Practice Address - Country:US
Practice Address - Phone:256-216-8863
Practice Address - Fax:256-216-5563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24562208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty