OrganizationActive
Great State 2019 Inc
NPI 1124757588 · Dermatology Physician · Tuscaloosa, AL
Provider details
- NPI number
- 1124757588
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Daniel Sparkman, Executive Director(205) 509-9055
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
4960 Rice Mine Rd Ne Ste 30a
Tuscaloosa, AL 35406-3136
Phone: (205) 509-9055
Approximate (ZIP-level) locationGet directions
Mailing address
4960 Rice Mine Rd Ne Ste 30a
Tuscaloosa, AL 35406-3136
Other names (DBA / former)
- Doing business as
- Great State Alabama
- Doing business as
- Great State Rural Clinics
Registry dates
- Enumerated
- 2022-06-09
- Last updated
- 2022-06-09
- Certified
- 2022-06-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.