Organization
SPECIALTY MEDICAL CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL RIASE JR. DPM (OWNER)
(205) 507-1264
Entity
Organization
Contact information
Practice address
535 JACK WARNER PKWY NE, G-2, TUSCALOOSA, AL 35404-5751
(205) 507-1264
Mailing address
PO BOX 278, DEMOPOLIS, AL 36732-0278
(205) 507-1264
(205) 507-1266
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
53
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529926930
—
AL
Enumeration date
11/24/2006
Last updated
07/07/2008
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