Healthcare Provider Details

I. General information

NPI: 1831137363
Provider Name (Legal Business Name): BIRMINGHAM RADIOLOGICAL GROUP, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1088 9TH AVE SW
BESSEMER AL
35022-4530
US

IV. Provider business mailing address

2000A SOUTHBRIDGE PKWY STE 300
BIRMINGHAM AL
35209-7704
US

V. Phone/Fax

Practice location:
  • Phone: 205-432-0100
  • Fax: 205-432-0105
Mailing address:
  • Phone: 205-871-4274
  • Fax: 205-871-4301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LARRY S SIMMA
Title or Position: BUSINESS MANAGER/CFO
Credential:
Phone: 205-871-4274