Basic Information
Provider Information
NPI: 1548369382
EntityType: 2
ReplacementNPI:  
OrganizationName: CULLMAN ANESTHESIOLOGY & PAIN CONSULTANTS PC
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Mailing Information
Address1: PO BOX 235022
Address2:  
City: MONTGOMERY
State: AL
PostalCode: 361235022
CountryCode: US
TelephoneNumber: 3343966930
FaxNumber: 3344811200
Practice Location
Address1: 1912 AL HIGHWAY 157
Address2:  
City: CULLMAN
State: AL
PostalCode: 350580609
CountryCode: US
TelephoneNumber: 2567372000
FaxNumber: 2567372598
Other Information
ProviderEnumerationDate: 09/21/2006
LastUpdateDate: 03/08/2012
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AuthorizedOfficialLastName: HALL
AuthorizedOfficialFirstName: ROBIN
AuthorizedOfficialMiddleName: TATE
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 3343966930
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IsOrganizationSubpart: N
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AuthorizedOfficialCredential: MD
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LP2900X  N193400000X MULTIPLE SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
207L00000X  Y193400000X MULTIPLE SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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