Provider Demographics
NPI:1053387654
Name:ANNISTON PATHOLOGY
Entity type:Organization
Organization Name:ANNISTON PATHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:W
Authorized Official - Middle Name:H
Authorized Official - Last Name:TALBOT
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:256-235-5271
Mailing Address - Street 1:PO BOX 968
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36202
Mailing Address - Country:US
Mailing Address - Phone:256-235-5271
Mailing Address - Fax:256-741-6400
Practice Address - Street 1:400 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207
Practice Address - Country:US
Practice Address - Phone:256-235-5271
Practice Address - Fax:256-741-6400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-24
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALE384Medicare PIN