Provider Demographics
NPI:1679018881
Name:INTEGRATED SLEEP DIAGNOSTIC
Entity Type:Organization
Organization Name:INTEGRATED SLEEP DIAGNOSTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-372-7803
Mailing Address - Street 1:PO BOX 3369
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36831-3369
Mailing Address - Country:US
Mailing Address - Phone:251-308-2843
Mailing Address - Fax:251-308-2843
Practice Address - Street 1:6925 COTTAGE HILL RD
Practice Address - Street 2:SUITE E
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-3715
Practice Address - Country:US
Practice Address - Phone:251-308-2843
Practice Address - Fax:251-308-2843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-23
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic