Healthcare Provider Details

I. General information

NPI: 1790253011
Provider Name (Legal Business Name): ZEPHRINE L BARNES HAIR LOSS SPECIALIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 11/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3411 COLONNADE PKWY STE 25
BIRMINGHAM AL
35243-3377
US

IV. Provider business mailing address

1349 WARRIOR RD
BIRMINGHAM AL
35218-3247
US

V. Phone/Fax

Practice location:
  • Phone: 205-746-4790
  • Fax:
Mailing address:
  • Phone: 205-746-4790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number110806
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: