Provider Demographics
NPI:1871530766
Name:BILLSBY, ALAN L (DO)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:L
Last Name:BILLSBY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 COX BLVD
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-4020
Mailing Address - Country:US
Mailing Address - Phone:256-383-4473
Mailing Address - Fax:256-381-5232
Practice Address - Street 1:342 COX BLVD
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-4020
Practice Address - Country:US
Practice Address - Phone:256-383-4473
Practice Address - Fax:256-381-5232
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO.1239208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1326373861OtherSHOALS PRIMARY CARE, LLC
AL1326373861OtherSHOALS PRIMARY CARE, LLC
MS00935378Medicaid
E75173Medicare UPIN
MS020000485Medicare PIN