Healthcare Provider Details

I. General information

NPI: 1144319914
Provider Name (Legal Business Name): ENDOCRINOLOGY AND INTERNAL MEDICINE ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2728 10TH AVE S STE 310
BIRMINGHAM AL
35205-1202
US

IV. Provider business mailing address

2728 10TH AVE S STE 310
BIRMINGHAM AL
35205-1202
US

V. Phone/Fax

Practice location:
  • Phone: 205-313-2650
  • Fax:
Mailing address:
  • Phone: 205-313-2650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number00013421
License Number StateAL

VIII. Authorized Official

Name: DR. DAVID D DEATKINE JR.
Title or Position: PRESIDENT
Credential: MD
Phone: 205-313-2650