Healthcare Provider Details

I. General information

NPI: 1700325396
Provider Name (Legal Business Name): DR FRANK A BROTHERTON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2017
Last Update Date: 02/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2018 BROOKWOOD MED CTR DR POB SUITE 310
BIRMINGHAM AL
35209-6898
US

IV. Provider business mailing address

2018 BROOKWOOD MED CTR DR POB SUITE 310
BIRMINGHAM AL
35209-6898
US

V. Phone/Fax

Practice location:
  • Phone: 205-329-7815
  • Fax: 205-329-7816
Mailing address:
  • Phone: 205-329-7815
  • Fax: 205-329-7816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number497
License Number StateAL

VIII. Authorized Official

Name: DR. FRANK A BROTHERTON
Title or Position: PROVIDER/OWNER
Credential: PHD
Phone: 205-329-7815