Provider Demographics
NPI:1831555218
Name:RETNA A BILLANO LLC
Entity type:Organization
Organization Name:RETNA A BILLANO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RETNA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BILLANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-591-2169
Mailing Address - Street 1:4325 DOLLY RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5701
Mailing Address - Country:US
Mailing Address - Phone:205-591-2169
Mailing Address - Fax:205-591-0815
Practice Address - Street 1:4325 DOLLY RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-5701
Practice Address - Country:US
Practice Address - Phone:205-591-2169
Practice Address - Fax:205-591-0815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-14
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16012301207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty