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Organization

JACK M ENGLERT MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JACK MANUEL ENGLERT MD (PRESIDENT)
(256) 517-1507
Entity
Organization

Contact information

Practice address
101 BOB WALLACE AVE SW, SUITE D, HUNTSVILLE, AL 35801-3847
(256) 517-1507
(256) 517-1508
Mailing address
101 BOB WALLACE AVE SW, SUITE D, HUNTSVILLE, AL 35801-3847
(256) 517-1507
(256) 517-1508

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AL15840
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051503250
MEDICARE PTAN
AL
01
E87616
UPIN
AL
Enumeration date
01/15/2010
Last updated
01/23/2010
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