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Individual

ASSIS SOARES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
401 MEDICAL PARK, TALLADEGA, AL 35160-2259
(256) 362-9239
(256) 761-1704
Mailing address
401 MEDICAL PARK, TALLADEGA, AL 35160-2259
(256) 362-9239
(256) 761-1704

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
10380
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000010678
AL
Enumeration date
11/02/2006
Last updated
12/02/2011
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