Provider Demographics
NPI:1831448372
Name:HUNTSVILLE HOSPITAL SURGICAL ASSOCIATES OF MADISON
Entity type:Organization
Organization Name:HUNTSVILLE HOSPITAL SURGICAL ASSOCIATES OF MADISON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:S
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-265-8818
Mailing Address - Street 1:PO BOX 2705
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-2705
Mailing Address - Country:US
Mailing Address - Phone:256-801-6036
Mailing Address - Fax:256-801-6218
Practice Address - Street 1:1041 BALCH RD STE 350
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8822
Practice Address - Country:US
Practice Address - Phone:256-265-5951
Practice Address - Fax:256-265-5952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL31838208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty