Organization
CHARLES BRENTNALL, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES B BRENTNALL MD (PRESIDENT)
(256) 249-0358
Entity
Organization
Contact information
Practice address
7 BROWN AVE, SYLACAUGA, AL 35150-2421
(256) 249-0358
(256) 249-8508
Mailing address
PO BOX 2190, SYLACAUGA, AL 35150-5190
(256) 249-0358
(256) 249-8508
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
00007246
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000002286
—
AL
05
—
000019927
—
AL
01
—
510-02286
BCBS OF ALABAMA
AL
01
—
510-19927
BCBS OF ALABAMA
AL
01
—
C71170
UPIN
AL
Enumeration date
04/02/2008
Last updated
05/01/2008
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