Provider Demographics
NPI:1912978792
Name:ALABAMA PULMONARY & CRITICAL CARE P.C.
Entity Type:Organization
Organization Name:ALABAMA PULMONARY & CRITICAL CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAYWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-834-5152
Mailing Address - Street 1:1722 PINE ST
Mailing Address - Street 2:SUITE 406
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1103
Mailing Address - Country:US
Mailing Address - Phone:334-834-5152
Mailing Address - Fax:334-834-5167
Practice Address - Street 1:1722 PINE ST
Practice Address - Street 2:SUITE 406
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1103
Practice Address - Country:US
Practice Address - Phone:334-834-5152
Practice Address - Fax:334-834-5167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20155207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-05275OtherBCBS
AL515-05275OtherBCBS
AL515-51379Medicare ID - Type Unspecified