Organization
EASTERN MEDICAL SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE P RONK (ADMINISTRATOR)
(205) 949-4446
Entity
Organization
Contact information
Practice address
150 GILBREATH DR, ONEONTA, AL 35121-2827
(205) 274-3344
Mailing address
48 MEDICAL PARK DR E, BIRMINGHAM, AL 35235-3400
(205) 949-4446
(205) 838-3206
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
10881
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009972390
—
AL
01
—
51503246
BLUE CROSS
AL
Enumeration date
05/15/2008
Last updated
05/15/2008
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