Basic Information
| Provider Information | |||||||||
| NPI: | 1023087509 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HURST | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2006 BROOKWOOD MEDICAL CTR DR | ||||||||
| Address2: | SUITE 202, WMP | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352096899 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053978850 | ||||||||
| FaxNumber: | 2053978855 | ||||||||
| Practice Location | |||||||||
| Address1: | 2006 BROOKWOOD MEDICAL CTR DR | ||||||||
| Address2: | SUITE 202, WMP | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352096899 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2058772850 | ||||||||
| FaxNumber: | 2058772858 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2006 | ||||||||
| LastUpdateDate: | 07/11/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 5984 | AL | Y | Other Service Providers | Specialist |
No ID Information.