Organization
OLIVE BRANCH DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMENA RAJA ALKESWANI MD (PRACTICE OWNER)
(727) 504-5883
Entity
Organization
Contact information
Practice address
4721 CHACE CIR, HOOVER, AL 35244-3700
(205) 266-9011
Mailing address
PO BOX 36263, BIRMINGHAM, AL 35236-6263
(205) 266-9011
(903) 200-1515
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A1254956
—
AL
Enumeration date
12/04/2024
Last updated
06/11/2026
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