Provider Demographics
NPI:1366444622
Name:BRINLEY, STEPHEN K (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:K
Last Name:BRINLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 229
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-0229
Mailing Address - Country:US
Mailing Address - Phone:662-620-7102
Mailing Address - Fax:662-620-7106
Practice Address - Street 1:205 MARENGO ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-6033
Practice Address - Country:US
Practice Address - Phone:256-381-0400
Practice Address - Fax:256-386-0065
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO-137174400000X
ALDO.1372085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000055298OtherMEDICARE PROVIDER NUMBER
AL009971905Medicaid
AL51531400OtherBC HALEYVILLE
AL009934436Medicaid
AL009911646Medicaid
AL009934434Medicaid
AL009911647Medicaid
AL51039506OtherBC ECM
AL51524659OtherBC OBGYN
AL528202620Medicaid
AL000039506Medicaid
AL51531399OtherBC RUSSELLVILLE
AL51543278OtherBC SHOALS
AL51543315OtherBC EAST
C300OtherMC GROUP
AL000055298OtherMEDICARE PROVIDER NUMBER
AL51039506OtherBC ECM