Provider Demographics
NPI:1477341519
Name:FALOLA PSYCHIATRY PRACTICE L.L.C
Entity type:Organization
Organization Name:FALOLA PSYCHIATRY PRACTICE L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FALOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-201-1502
Mailing Address - Street 1:289 GLEN CROSS DR
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-0020
Mailing Address - Country:US
Mailing Address - Phone:205-201-1502
Mailing Address - Fax:949-703-8754
Practice Address - Street 1:289 GLEN CROSS DR
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-0020
Practice Address - Country:US
Practice Address - Phone:205-201-1502
Practice Address - Fax:949-703-8754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty