Basic Information
| Provider Information | |||||||||
| NPI: | 1225126154 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SUMRALL | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | HINSON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7987 | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366700987 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516330573 | ||||||||
| FaxNumber: | 2516337367 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 MEMORIAL HOSPITAL DR STE 1A | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 36608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2513436848 | ||||||||
| FaxNumber: | 2513435708 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2006 | ||||||||
| LastUpdateDate: | 06/28/2019 | ||||||||
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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 | 207RC0200X | 29562 | AL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | 19069 | MS | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RP1001X | 29562 | AL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 111128 | 05 | AL | MEDICAID | 220937 | 05 | AL | MEDICAID | 3588081 | 01 | AL | CIGNA HC | OTHER | 9145349 | 01 | AL | AETNA | OTHER | 220450 | 05 | AL | MEDICAID | 213198 | 05 | AL | MEDICAID | 510-49655 | 01 | AL | BCBS | OTHER | 00287022 | 01 | MS | MS MEDICAID | OTHER | 102I818464 | 01 | AL | MEDICARE | OTHER | 3067814 | 01 | AL | UHC | OTHER | P00749112 | 01 | AL | RR MEDICARE | OTHER | 511-95743 | 01 | AL | BCBS | OTHER | 512-07152 | 01 | AL | BCBS | OTHER | 213248 | 05 | AL | MEDICAID | Z10194 | 01 | AL | VIVA HEALTH | OTHER | 207933 | 05 | AL | MEDICAID | 512-07155 | 01 | AL | BCBS | OTHER |