Provider Demographics
NPI:1851426068
Name:NORTH ALABAMA FAMILY PRACTICE, PC
Entity Type:Organization
Organization Name:NORTH ALABAMA FAMILY PRACTICE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:REILAND
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:256-593-0251
Mailing Address - Street 1:11744 US HIGHWAY 431
Mailing Address - Street 2:
Mailing Address - City:BOAZ
Mailing Address - State:AL
Mailing Address - Zip Code:35956-2104
Mailing Address - Country:US
Mailing Address - Phone:256-593-0251
Mailing Address - Fax:256-593-0076
Practice Address - Street 1:11744 US HIGHWAY 431
Practice Address - Street 2:
Practice Address - City:BOAZ
Practice Address - State:AL
Practice Address - Zip Code:35956-2104
Practice Address - Country:US
Practice Address - Phone:256-593-0251
Practice Address - Fax:256-593-0076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL=========OtherTAX ID NUMBER