Healthcare Provider Details

I. General information

NPI: 1801828405
Provider Name (Legal Business Name): KEVIN S WINDSOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 MONTCLAIR RD SUITE 675
BIRMINGHAM AL
35213-1972
US

IV. Provider business mailing address

500 OFFICE PARK DR SUITE 400
BIRMINGHAM AL
35223-2437
US

V. Phone/Fax

Practice location:
  • Phone: 205-592-5077
  • Fax: 205-599-4738
Mailing address:
  • Phone: 205-803-4330
  • Fax: 205-803-4354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number13842
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: