Provider Demographics
NPI:1417362807
Name:WEST ALABAMA PHYSICIAN ASSOCIATES LLC
Entity type:Organization
Organization Name:WEST ALABAMA PHYSICIAN ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER REPRESENTATIVE
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:D
Authorized Official - Last Name:CAPLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-333-4657
Mailing Address - Street 1:1716 TEMPLE AVE N
Mailing Address - Street 2:SUITE 1 & 2
Mailing Address - City:FAYETTE
Mailing Address - State:AL
Mailing Address - Zip Code:35555-1309
Mailing Address - Country:US
Mailing Address - Phone:205-932-1280
Mailing Address - Fax:205-932-1260
Practice Address - Street 1:1716 TEMPLE AVE N
Practice Address - Street 2:SUITE 1 & 2
Practice Address - City:FAYETTE
Practice Address - State:AL
Practice Address - Zip Code:35555-1309
Practice Address - Country:US
Practice Address - Phone:205-932-1280
Practice Address - Fax:205-932-1260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty