Healthcare Provider Details

I. General information

NPI: 1659337574
Provider Name (Legal Business Name): THOMAS HILTON CAWTHON JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 08/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 PRINCETON AVE SW SUITE 707
BIRMINGHAM AL
35211-1310
US

IV. Provider business mailing address

801 PRINCETON AVE SW SUITE 707
BIRMINGHAM AL
35211-1310
US

V. Phone/Fax

Practice location:
  • Phone: 205-780-4330
  • Fax: 205-780-7775
Mailing address:
  • Phone: 205-780-4330
  • Fax: 205-780-7775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number00021298
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: