| University Diagnostics Of Tuscaloosa, Inc | |
|
701 University Blvd E Ste 204 Tuscaloosa AL 35401-7431 | |
| (205) 553-9171 | |
| (205) 553-9127 |
| Full Name | University Diagnostics Of Tuscaloosa, Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 701 University Blvd E Ste 204, Tuscaloosa, Alabama |
| Authorized Official Name and Position | Gary Newsom (PHYSICIAN) |
| Authorized Official Contact | 2053491571 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| University Diagnostics Of Tuscaloosa, Inc 1435 2nd Ct E Tuscaloosa AL 35401-3276 Ph: (205) 349-1571 | University Diagnostics Of Tuscaloosa, Inc 701 University Blvd E Ste 204 Tuscaloosa AL 35401-7431 Ph: (205) 553-9171 |
| NPI Number | 1063718542 |
|---|---|
| Provider Enumeration Date | 02/01/2011 |
| Last Update Date | 09/17/2015 |
| Medicare PECOS PAC ID | 5698957819 |
|---|---|
| Medicare Enrollment ID | O20110309000776 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063718542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 21330 (Alabama) | Primary |
| Provider Name | Gary Randell Newsom |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992723019 PECOS PAC ID: 1052216785 Enrollment ID: I20031205000079 |
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