Provider Demographics
NPI:1053097717
Name:MINIMALLY INVASIVE SURGEONS OF ALABAMA
Entity type:Organization
Organization Name:MINIMALLY INVASIVE SURGEONS OF ALABAMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:D
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-325-7339
Mailing Address - Street 1:901 LEIGHTON AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5703
Mailing Address - Country:US
Mailing Address - Phone:732-325-7339
Mailing Address - Fax:256-405-0160
Practice Address - Street 1:901 LEIGHTON AVE STE 102
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5703
Practice Address - Country:US
Practice Address - Phone:732-325-7339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty