Provider Demographics
NPI:1891099537
Name:SALINE PHYSICIAN SERVICES, LLC
Entity Type:Organization
Organization Name:SALINE PHYSICIAN SERVICES, LLC
Other - Org Name:SALINE OB/GYN ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:DON
Authorized Official - Last Name:ALFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-776-6015
Mailing Address - Street 1:PO BOX 9150
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002-9150
Mailing Address - Country:US
Mailing Address - Phone:270-744-9600
Mailing Address - Fax:270-744-0834
Practice Address - Street 1:23157 I 30
Practice Address - Street 2:SUITE 200
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-2592
Practice Address - Country:US
Practice Address - Phone:501-847-0834
Practice Address - Fax:501-847-1731
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SALINE PHYSICIAN SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty