Provider Demographics
NPI:1043284490
Name:SLEEP DISORDERS CENTER OF ALABAMA
Entity type:Organization
Organization Name:SLEEP DISORDERS CENTER OF ALABAMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:DOEKEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:205-599-1020
Mailing Address - Street 1:790 MONTCLAIR RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1966
Mailing Address - Country:US
Mailing Address - Phone:205-599-1020
Mailing Address - Fax:205-599-1029
Practice Address - Street 1:790 MONTCLAIR RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1966
Practice Address - Country:US
Practice Address - Phone:205-599-1020
Practice Address - Fax:205-599-1029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL06006326174400000X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529301210Medicaid
ALE436Medicare PIN