MEDICARE: GORDON J KIRSCHBERG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	00008096	AL

General Provider Information

NPI Number	:	1588645535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GORDON J KIRSCHBERG MD

Provider Business Mailing Address
First Line	:	2018 BROOKWOOD MED CTR DR
Second Line	:	ST 202
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-6898
Country	:	US
Telephone Number	:	205-879-4200
Fax Number	:	205-870-7372

Provider Business Practice Location Address
First Line	:	2018 BROOKWOOD MED CTR DR
Second Line	:	ST 202
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-6898
Country	:	US
Telephone Number	:	205-879-4200
Fax Number	:	205-870-7372

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	07/08/2007

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