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Great State 2019 Inc — NPI 1124757588, Tuscaloosa, AL | NPI Central

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NPI 1124757588

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

Dermatology PhysicianPrimary207N00000X
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

More AL providers

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.