Provider Demographics
NPI:1972558252
Name:OPELIKA CARDIOVASCULAR & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:OPELIKA CARDIOVASCULAR & ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MD
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:AIKENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-203-1232
Mailing Address - Street 1:107 24TH ST
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-6253
Mailing Address - Country:US
Mailing Address - Phone:334-203-1232
Mailing Address - Fax:334-203-4269
Practice Address - Street 1:107 NORTH 24TH STREET
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801
Practice Address - Country:US
Practice Address - Phone:334-826-5577
Practice Address - Fax:334-826-7003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19164207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALK837Medicaid
AL051533558Medicaid
AL051533558Medicare UPIN