Maxillofacial Surgery Center of Huntsville, Inc.

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

MAXILLOFACIAL SURGERY CENTER OF HUNTSVILLE, INC.

Practice address

1107 Gleneagles Dr SW
Huntsville, AL 35801-6405

Phone

(256) 882-3312

Fax

(256) 882-9472

NPI assigned

May 8, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Leroy A Kamelchuk, D.D.S., M.D.NPI 1528101698

Title

DDS MD

Phone

(256) 882-3312

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leroy A Kamelchuk, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Huntsville, AL
  • NPI 1528101698
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1972716710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 GLENEAGLES DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016405",
            "telephone_number": "256-882-3312",
            "fax_number": "256-882-9472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 GLENEAGLES DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016405",
            "telephone_number": "256-882-3312",
            "fax_number": "256-882-9472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXILLOFACIAL SURGERY CENTER OF HUNTSVILLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "KAMELCHUK",
        "authorized_official_first_name": "LEROY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DDS MD",
        "authorized_official_telephone_number": "256-882-3312",
        "authorized_official_credential": "D.D.S., M.D."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miller Matzek, DPT
• Caroline Makey Mauldin, CRNP
• Jessica Dawn Maulick, PHARMD
• Max Health, LLC
• Max-Well Therapy
• David Randall Maxwell
• Jazmine Maxwell, MSW
• Lyndell Maxwell, MSW
• Carol P May, PHARMD
• Patricia Yvonne May

• Oral and Maxillofacial Surgery Clinic/Center in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.