Provider Demographics
NPI:1790795011
Name:ANES. ASSC. OF N. ALABAMA
Entity Type:Organization
Organization Name:ANES. ASSC. OF N. ALABAMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:METCALF
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:256-734-5007
Mailing Address - Street 1:1716 EVA RD NE
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-6006
Mailing Address - Country:US
Mailing Address - Phone:256-734-5007
Mailing Address - Fax:256-734-0545
Practice Address - Street 1:1716 EVA RD NE
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-6006
Practice Address - Country:US
Practice Address - Phone:256-734-5007
Practice Address - Fax:256-734-0545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALH570OtherMEDICARE GROUP #
ALH572OtherMEDICARE GROUP #
ALI450OtherMEDICARE GROUP #
ALH570OtherMEDICARE GROUP #