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Contact Information

SHOALS INFECTIOUS DISEASE CONSULTANTS LLC
22281 US HIGHWAY 72 STE A
ATHENS, AL35613-2601
 Phone: 256-444-4401
 Fax: 256-444-4403
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Infectious Disease

207RI0200X 11 Physician/Internal Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Wound Care

163WW0000X
Indicates primary specialty

NPI Profile & details for SHOALS INFECTIOUS DISEASE CONSULTANTS LLC

NPI Number 1083192173
LBN Legal business name SHOALS INFECTIOUS DISEASE CONSULTANTS LLC
Authorized official JEAN VINCENT - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/01/2018
Last updated 08/23/2021 - About 5 years ago
Identifiers
License # 180531025
License # MD.36985
AL Medicaid 219543
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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