Organization
WEST ALABAMA NEPHROLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEOFFREY N ALILONU M.D. (OWNER)
(205) 345-6302
Entity
Organization
Contact information
Practice address
4400 WATERMELON RD, SUITE B, NORTHPORT, AL 35473-5204
(205) 345-6302
(205) 247-4300
Mailing address
4400 WATERMELON RD, SUITE B, NORTHPORT, AL 35473-5204
(205) 345-6302
(205) 247-4300
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9748
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000037267
—
AL
05
—
103380
—
AL
01
—
28996
AL LICENSE
AL
01
—
51037267
BCBS
AL
01
—
51591962
BCBS NUMBER
AL
05
—
529603880
—
AL
01
—
9748
AL LICENSE
AL
Enumeration date
12/07/2006
Last updated
05/13/2015
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