Provider Demographics
NPI:1366406514
Name:BIRMINGHAM GASTROENTEROLOGY ASSOCIATES PC
Entity type:Organization
Organization Name:BIRMINGHAM GASTROENTEROLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:THERIOT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:205-271-8000
Mailing Address - Street 1:1 INDEPENDENCE PLAZA
Mailing Address - Street 2:SUITE 900
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209
Mailing Address - Country:US
Mailing Address - Phone:205-271-8000
Mailing Address - Fax:205-879-0548
Practice Address - Street 1:1 INDEPENDENCE PLAZA
Practice Address - Street 2:SUITE 900
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209
Practice Address - Country:US
Practice Address - Phone:205-271-8000
Practice Address - Fax:205-879-0548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty