Provider Demographics
NPI:1912050352
Name:VALLEY EAR NOSE AND THROAT ASSOCIATES PC
Entity Type:Organization
Organization Name:VALLEY EAR NOSE AND THROAT ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIX
Authorized Official - Suffix:
Authorized Official - Credentials:CMC
Authorized Official - Phone:256-777-9024
Mailing Address - Street 1:15232 GREENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35613-2897
Mailing Address - Country:US
Mailing Address - Phone:256-233-1650
Mailing Address - Fax:256-233-7244
Practice Address - Street 1:15232 GREENFIELD DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35613
Practice Address - Country:US
Practice Address - Phone:256-233-1650
Practice Address - Fax:256-233-7244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14357174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALE45268Medicare UPIN
ALI06438Medicare UPIN