Provider Demographics
NPI:1639103666
Name:RHEUMATOLOGY ASSOCIATES OF NORTH ALABAMA, PC
Entity Type:Organization
Organization Name:RHEUMATOLOGY ASSOCIATES OF NORTH ALABAMA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN CREDENTIALER
Authorized Official - Prefix:MS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:DUFOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-704-7040
Mailing Address - Street 1:720 GALLATIN STREET
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4414
Mailing Address - Country:US
Mailing Address - Phone:256-551-6510
Mailing Address - Fax:256-551-6507
Practice Address - Street 1:720 GALLATIN STREET
Practice Address - Street 2:SUITE 500
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4414
Practice Address - Country:US
Practice Address - Phone:256-551-6510
Practice Address - Fax:256-551-6507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL528600320Medicaid
AL528600320Medicaid