Basic Information
Provider Information
NPI: 1962408096
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HALE
FirstName: JAMES
MiddleName: ALAN
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2151 OLD ROCKY RIDGE RD
Address2: STE 106
City: BIRMINGHAM
State: AL
PostalCode: 352167251
CountryCode: US
TelephoneNumber: 2059891080
FaxNumber: 2059891087
Practice Location
Address1: 2010 BROOKWOOD MEDICAL CTR DR
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352096804
CountryCode: US
TelephoneNumber: 2059891080
FaxNumber: 2059891087
Other Information
ProviderEnumerationDate: 06/23/2005
LastUpdateDate: 09/08/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XMD.18159ALY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
00007917305AL MEDICAID


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