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1164474623
STEPHEN BLAKELY EZZELL
DOTHAN, AL
NPI
1164474623
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: AL 1083935)
Enumeration Date
2006-05-16
Last Update Date
2007-07-08
Business Address
-- STEPHEN BLAKELY EZZELL CRNA
4370 W MAIN ST
DOTHAN, AL 36305-1056
Phone number: 334-793-5000
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Mailing Address
-- STEPHEN BLAKELY EZZELL CRNA
PO BOX 6907
DOTHAN, AL 36302
Phone number: 334-793-5000
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