Provider Demographics
NPI:1053027276
Name:IES ALABAMA PLLC
Entity type:Organization
Organization Name:IES ALABAMA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AO
Authorized Official - Prefix:
Authorized Official - First Name:NESTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZENAROSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-420-5527
Mailing Address - Street 1:PO BOX 3347
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-3347
Mailing Address - Country:US
Mailing Address - Phone:469-420-5527
Mailing Address - Fax:
Practice Address - Street 1:1613 N MCKENZIE ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-2247
Practice Address - Country:US
Practice Address - Phone:251-949-3540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty