Organization
CHARLES F ALBERT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES ALBERT M.D. (OWNER)
(256) 810-3036
Entity
Organization
Contact information
Practice address
210 INDIAN SPRINGS DR, FLORENCE, AL 35634-2056
(256) 810-3036
Mailing address
210 INDIAN SPRINGS DR, FLORENCE, AL 35634-2056
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
15691
AL
363LF0000X
Family Nurse Practitioner
1-063128
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000083440
—
AL
01
—
01D0723250
CLIA
—
01
—
1033180104
NPI
AL
01
—
1275629941
NPI
AL
01
—
15691
STATE LICENSE
AL
01
—
I230
GROUP
AL
Enumeration date
02/09/2007
Last updated
01/07/2013
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