Provider profile · NPI 1205356938

Alabama State University

Orthopaedic Surgery, Sports Medicine · Montgomery, AL · NPI 1205356938 · No federal exclusion match

✔ Verified against the public CMS NPPES registry & HHS-OIG LEIE as of Jun 22, 2026. Source-linked, daily-refreshed. Public data only — no PHI.

Registry details

Type

Organization

Primary specialty

Orthopaedic Surgery, Sports Medicine

Enumerated

Jun 23, 2017

License(s)

32588 (AL)

Addresses on file

PurposeAddressCity/StatePhone
MAILING5050 SPRING VALLEY RD Dallas, TX 75244-3995
LOCATION915 S JACKSON ST Montgomery, AL 36104-5716972-367-4845

View on NPPES registry ↗

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