Provider Demographics
NPI:1679642805
Name:ALABAMA NEUROLOGY ASSOCIATES
Entity type:Organization
Organization Name:ALABAMA NEUROLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:BYRON
Authorized Official - Last Name:RISER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-803-2210
Mailing Address - Street 1:3105 INDEPENDENCE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4111
Mailing Address - Country:US
Mailing Address - Phone:205-580-2210
Mailing Address - Fax:205-803-2214
Practice Address - Street 1:3105 INDEPENDENCE DR STE 105
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4111
Practice Address - Country:US
Practice Address - Phone:205-803-2210
Practice Address - Fax:205-803-2214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12140174400000X
2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051505043Medicaid
AL529912740Medicaid
AL051505043Medicaid
AL051505043Medicare ID - Type UnspecifiedPROVIDER NUMBER