Provider Demographics
NPI:1356798649
Name:HLAVACEK, CYNTHIA M (MD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:HLAVACEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5430
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36205-0430
Mailing Address - Country:US
Mailing Address - Phone:256-237-1624
Mailing Address - Fax:256-241-2277
Practice Address - Street 1:817 PRINCETON AVE SW
Practice Address - Street 2:POB II; SUITE 106
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1333
Practice Address - Country:US
Practice Address - Phone:205-783-3191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL37145208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery