Basic Information
Provider Information
NPI: 1629205182
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BORNSTEIN
FirstName: JOSEPH
MiddleName: E
NamePrefix: DR.
NameSuffix:  
Credential: MD, MBA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6701 AIRPORT BLVD STE D143
Address2:  
City: MOBILE
State: AL
PostalCode: 366086701
CountryCode: US
TelephoneNumber: 2513423949
FaxNumber: 2512663361
Practice Location
Address1: 6701 AIRPORT BLVD STE A208
Address2:  
City: MOBILE
State: AL
PostalCode: 366083763
CountryCode: US
TelephoneNumber: 2516331981
FaxNumber: 2516313298
Other Information
ProviderEnumerationDate: 06/11/2009
LastUpdateDate: 02/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X272632NYN Allopathic & Osteopathic PhysiciansSurgery 
208600000XL-239969MAN Allopathic & Osteopathic PhysiciansSurgery 
208600000XMD.34455ALY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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