Provider Demographics
NPI:1851473409
Name:ENRIQUE DUPRAT MD PC
Entity Type:Organization
Organization Name:ENRIQUE DUPRAT MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRCHFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-745-0211
Mailing Address - Street 1:5211 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36854-3556
Mailing Address - Country:US
Mailing Address - Phone:334-756-8800
Mailing Address - Fax:334-756-8802
Practice Address - Street 1:5211 20TH AVE
Practice Address - Street 2:
Practice Address - City:VALLEY
Practice Address - State:AL
Practice Address - Zip Code:36854-3556
Practice Address - Country:US
Practice Address - Phone:334-756-8800
Practice Address - Fax:334-756-8802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALK125Medicare PIN