Provider Demographics
NPI:1750404281
Name:ANTHONY, MILTON DOY (ALC)
Entity type:Individual
Prefix:
First Name:MILTON
Middle Name:DOY
Last Name:ANTHONY
Suffix:
Gender:M
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 POLK DR NE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-1775
Mailing Address - Country:US
Mailing Address - Phone:256-536-3726
Mailing Address - Fax:
Practice Address - Street 1:2020 POLK DR NE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-1775
Practice Address - Country:US
Practice Address - Phone:256-536-3726
Practice Address - Fax:256-536-2929
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC1254A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-35262OtherBLUE CROSS OF ALABAMA