Organization
THE SURGICAL CLINIC OF ANNISTON, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL G SISSON (PHYSICIAN CREDENTIALING MANAGER)
(256) 237-1624
Entity
Organization
Contact information
Practice address
111 TOWN CENTER DRIVE, ANNISTON, AL 36205-4102
(256) 237-1624
(256) 241-2277
Mailing address
PO BOX 5430, ANNISTON, AL 36205-0430
(256) 241-6310
(256) 241-2277
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528200290
—
AL
Enumeration date
02/07/2006
Last updated
10/21/2022
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