Basic Information
| Provider Information | |||||||||
| NPI: | 1518107119 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ST. VINCENT'S HOSPITAL | ||||||||
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| OtherOrganizationName: | ST. VINCENT'S BIRMINGHAM PHYSICIANS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50 MEDICAL PARK EAST DRIVE | ||||||||
| Address2: | FINANCE DEPARTMENT | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352353401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2058383343 | ||||||||
| FaxNumber: | 2058386119 | ||||||||
| Practice Location | |||||||||
| Address1: | 810 SAINT VINCENTS DR | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352051601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059397000 | ||||||||
| FaxNumber: | 2058383102 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2009 | ||||||||
| LastUpdateDate: | 09/06/2017 | ||||||||
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| AuthorizedOfficialLastName: | WILLIAMS | ||||||||
| AuthorizedOfficialFirstName: | BRANDON | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 2058383718 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 363AS0400X | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.