Provider Demographics
NPI:1659442879
Name:CASALS CLINIC INC
Entity Type:Organization
Organization Name:CASALS CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEON
Authorized Official - Middle Name:C
Authorized Official - Last Name:CASALS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:334-273-1224
Mailing Address - Street 1:316 SAINT LUKES DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7102
Mailing Address - Country:US
Mailing Address - Phone:334-273-1224
Mailing Address - Fax:334-273-1225
Practice Address - Street 1:316 SAINT LUKES DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7102
Practice Address - Country:US
Practice Address - Phone:334-273-1224
Practice Address - Fax:334-273-1225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19059261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALF73255Medicare UPIN