| Name: | West Alabama Internal Medicine L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 14 Feb 2005 (20 years ago) |
| Entity Number: | 000-460-447 |
| Register Number: | 000460447 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Principal Address: | TUSCALOOSA, AL |
| Registered Office Street Address: | 701 UNIVERSITY BLVD E STE 810TUSCALOOSA, AL 35401 |
| Registered Office Street Address ZIP Code: | 35401 |
Activities
RENDERING HEALTHCARE SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881761013 | 2006-11-30 | 2016-01-06 | 701 UNIVERSITY BLVD E, SUITE 810, TUSCALOOSA, AL, 354012086, US | 701 UNIVERSITY BLVD E, SUITE 810, TUSCALOOSA, AL, 354012086, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 205-366-0009 |
| Fax | 2053660097 |
Authorized person
| Name | DR. WILLIAM KEITH DEBELL SR. |
| Role | PHYSICIAN PART OWNER |
| Phone | 2053660009 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529923040 |
| State | AL |
| Issuer | MEDICARE RAILROAD |
| Number | DC8873 |
| State | AL |
| Name | Role |
|---|---|
| DEBELL, WILLIAM K | Agent |
| Name | Role |
|---|---|
| WILLIAM K DEBELL PC | Member |
| DEBRA DAVIS INC | Member |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
