Provider Demographics
NPI:1174611081
Name:BIRMINGHAM PEDIATRIC ASSOC
Entity type:Organization
Organization Name:BIRMINGHAM PEDIATRIC ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-933-2750
Mailing Address - Street 1:806 ST VINCENTS DRIVE
Mailing Address - Street 2:SUITE 615
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205
Mailing Address - Country:US
Mailing Address - Phone:205-933-2750
Mailing Address - Fax:205-939-4614
Practice Address - Street 1:806 ST VINCENTS DRIVE
Practice Address - Street 2:SUITE 615
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205
Practice Address - Country:US
Practice Address - Phone:205-933-2750
Practice Address - Fax:205-939-4614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty