Healthcare Provider Details

I. General information

NPI: 1235429481
Provider Name (Legal Business Name): MICHAEL GARRETT HURST M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2011
Last Update Date: 02/01/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CH19 STE 219 1720 2ND AVE SO.
BIRMINGHAM AL
35294-2041
US

IV. Provider business mailing address

CH19 STE 219 1720 2ND AVE SO.
BIRMINGHAM AL
35294-2041
US

V. Phone/Fax

Practice location:
  • Phone: 205-975-8197
  • Fax:
Mailing address:
  • Phone: 205-975-8197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number33184
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number33184
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: