Healthcare Provider Details

I. General information

NPI: 1831163724
Provider Name (Legal Business Name): JOANNA SIEGEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 03/08/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 SAINT VINCENTS DR STE 300 POB III
BIRMINGHAM AL
35205-1612
US

IV. Provider business mailing address

833 SAINT VINCENTS DR STE 300 POB III
BIRMINGHAM AL
35205-1612
US

V. Phone/Fax

Practice location:
  • Phone: 205-939-4512
  • Fax: 205-939-4519
Mailing address:
  • Phone: 205-939-4512
  • Fax: 205-939-4519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD00024869
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: