Healthcare Provider Details

I. General information

NPI: 1265361752
Provider Name (Legal Business Name): GARETH DUTTON PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 19TH STREET SOUTH
BIRMINGHAM AL
35294-0001
US

IV. Provider business mailing address

701 19TH STREET SOUTH
BIRMINGHAM AL
35294-0001
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-6876
  • Fax:
Mailing address:
  • Phone: 205-934-6876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1943
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: