Organization
SURGERY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANETTE KEENER (BILLING MANAGER)
(256) 547-6331
Entity
Organization
Contact information
Practice address
419 S 5TH ST, GADSDEN, AL 35901-5101
(256) 547-6331
(256) 547-1711
Mailing address
419 S 5TH ST, GADSDEN, AL 35901-5101
(256) 547-6331
(256) 547-1711
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
AL
2086S0129X
Vascular Surgery Physician
—
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528202650
—
AL
Enumeration date
04/27/2006
Last updated
08/17/2011
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