Provider Demographics
NPI:1356540728
Name:EXPRESSCLINIC, INC
Entity type:Organization
Organization Name:EXPRESSCLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CASWALL
Authorized Official - Middle Name:C
Authorized Official - Last Name:HARRIGAN
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:256-426-0802
Mailing Address - Street 1:8045 HIGHWAY 72 W
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-9564
Mailing Address - Country:US
Mailing Address - Phone:256-426-0802
Mailing Address - Fax:
Practice Address - Street 1:717 PRATT AVE NE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3645
Practice Address - Country:US
Practice Address - Phone:256-426-0802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty