Organization
GADSDEN PULMONARY & SLEEP CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTA J AUTWELL (ADM. ASST.)
(256) 547-4443
Entity
Organization
Contact information
Practice address
311 S 4TH ST, GADSDEN, AL 35901-5212
(256) 547-4443
(256) 547-4476
Mailing address
311 S 4TH ST, GADSDEN, AL 35901-5212
(256) 547-4443
(256) 547-4476
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
00017313
AL
207RP1001X
Pulmonary Disease Physician
Primary
00017313
AL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
00017313
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009925660
—
AL
01
—
1609855063
INDIVIDUAL NPI
AL
01
—
1639391162
ORGANIZATIONAL (GROUP) NATIONAL PROVIDER IDENTIFIER
AL
01
—
510-85402
BCBS PROVIDER NUMBER
AL
05
—
529904380
—
AL
Enumeration date
05/03/2007
Last updated
05/27/2015
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