Irvine, Samuel Oliver Starke

Irvine, Samuel Oliver Starke is an individual health care provider with primary practice located at 454 Taylor Rd , Montgomery AL 36117-3563. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Irvine, Samuel Oliver Starke can be contacted via phone (334) 613-9000.

Contact Information

Primary practice address
454 Taylor Rd Montgomery AL 36117-3563
Phone: (334) 613-9000
Fax: (334) 532-0056
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA-189 Alabama
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA.189 Alabama

Profile Details

NPI number 1376590059
LBN Legal business name Irvine, Samuel Oliver Starke
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 28th, 2006
Last updated May 23rd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376590059 NPPES
Alabama MEDICAID 009934027
Alabama MEDICAID 009989995
Alabama MEDICAID 009989985
Alabama Other 051001143
Alabama Other 051001307
Alabama Other 051001308

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