Provider Demographics
NPI:1760447510
Name:ANNISTON OBGYN ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:ANNISTON OBGYN ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:LIMERICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-237-6755
Mailing Address - Street 1:901 LEIGHTON AVE
Mailing Address - Street 2:SUITE 501
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5700
Mailing Address - Country:US
Mailing Address - Phone:256-237-6755
Mailing Address - Fax:256-236-1823
Practice Address - Street 1:901 LEIGHTON AVE
Practice Address - Street 2:SUITE 501
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5700
Practice Address - Country:US
Practice Address - Phone:256-237-6755
Practice Address - Fax:256-236-1823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALCD6837OtherMEDICARE RAILROAD CARRIER
ALCD6837OtherMEDICARE RAILROAD CARRIER