Healthcare Provider Details

I. General information

NPI: 1659301265
Provider Name (Legal Business Name): BRIAN CHARLES GOBER MAT, ATC, NREMT-P
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BRIAN CHARLES GOBER MAT, ATC, NREMT-P

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 VOLKER HALL L209 UNIVERSITY BLVD
BIRMINGHAM AL
35294-0001
US

IV. Provider business mailing address

2481 MIKELL RD
HAYDEN AL
35079-9003
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-5870
  • Fax:
Mailing address:
  • Phone: 205-229-3287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number9900084
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: