Healthcare Provider Details

I. General information

NPI: 1871410258
Provider Name (Legal Business Name): JOHN ANTHONY DI GIACOMO RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOHN ANTHONY DIGIACOMO

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 UNIVERSITY BLVD
BIRMINGHAM AL
35233-1815
US

IV. Provider business mailing address

418 22ND AVE S
BIRMINGHAM AL
35205-6946
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-6424
  • Fax:
Mailing address:
  • Phone: 305-321-9900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-180804
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: