Healthcare Provider Details

I. General information

NPI: 1609026418
Provider Name (Legal Business Name): SHELBY BAPTIST HEALTH CENTER ENDOCRINOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 09/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 1ST ST N SUITE 250
ALABASTER AL
35007-8608
US

IV. Provider business mailing address

200 BEACON PKWY W SUITE 330
BIRMINGHAM AL
35209-3102
US

V. Phone/Fax

Practice location:
  • Phone: 205-620-8672
  • Fax: 205-620-8673
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN BLACKBURN
Title or Position: INTERIM PRESIDENT & CEO
Credential:
Phone: 205-715-5901