Organization
EAST ALABAMA CARDIAC AND THORACIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY MARIE FARR (OFFICE MANAGER)
(334) 528-1720
Entity
Organization
Contact information
Practice address
2000 PEPPERELL PKWY, OPELIKA, AL 36801-5452
(334) 528-1720
(334) 528-1693
Mailing address
2000 PEPPERELL PKWY, PO BOX 2740, OPELIKA, AL 36801-5452
(334) 528-1720
(334) 528-1693
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19855
AL
174400000X
Specialist
22312
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009960240
—
AL
05
—
110274
—
AL
Enumeration date
12/15/2006
Last updated
10/16/2009
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