Organization
ANDALUSIA GREATER REGIONAL OTOLARYNGOLOGY ENT P C
Active
Other names
AGRO ENT
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICKEY G LOVE M.D. (DOCTOR/PRESIDENT)
(334) 427-2476
Entity
Organization
Contact information
Practice address
300 MEDICAL AVENUE, 2, ANDALUSIA, AL 36420-1201
(334) 427-2476
(334) 427-2477
Mailing address
300 MEDICAL AVENUE, 2, ANDALUSIA, AL 36420-1201
(334) 427-2476
(334) 427-2477
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12982
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529914990
—
AL
Enumeration date
02/20/2008
Last updated
12/19/2016
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