Provider Demographics
NPI:1831388255
Name:ALABAMA ANESTHESIOLOGY AND PAIN CONSULTANTS P.C.
Entity type:Organization
Organization Name:ALABAMA ANESTHESIOLOGY AND PAIN CONSULTANTS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-338-6655
Mailing Address - Street 1:2804 DR. JOHN HAYNES DRIVE
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-1438
Mailing Address - Country:US
Mailing Address - Phone:205-338-6655
Mailing Address - Fax:205-338-6658
Practice Address - Street 1:2804 DR. JOHN HAYNES DRIVE
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125-1438
Practice Address - Country:US
Practice Address - Phone:205-338-6655
Practice Address - Fax:205-338-6658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPTAN 6721890001OtherMEDICARE DMERC JURISDICTION C
ALDQ1146OtherRAILROAD MEDICARE
ALDQ1146OtherRAILROAD MEDICARE
ALPTAN 6721890001OtherMEDICARE DMERC JURISDICTION C