Healthcare Provider Details

I. General information

NPI: 1962401257
Provider Name (Legal Business Name): ASHLEY A. TAMUCCI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 BROOKWOOD MEDICAL CTR DR SUITE 300
BIRMINGHAM AL
35209-6899
US

IV. Provider business mailing address

2006 BROOKWOOD MEDICAL CTR DR SUITE 300
BIRMINGHAM AL
35209-6899
US

V. Phone/Fax

Practice location:
  • Phone: 205-397-8850
  • Fax: 205-397-8855
Mailing address:
  • Phone: 205-397-8850
  • Fax: 205-397-8855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number00020905
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: