Individual
LAUREN HOBART WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
305 PAUL BRYANT DRIVE E, TUSCALOOSA, AL 35403-2055
(205) 345-0192
(205) 247-2194
Mailing address
305 PAUL W BRYANT DR E, TUSCALOOSA, AL 35401-2055
(205) 345-0192
(205) 759-8794
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-573
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051060244
BLUE CROSS BLUE SHIELD
AL
Enumeration date
01/22/2008
Last updated
06/09/2025
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