Healthcare Provider Details

I. General information

NPI: 1679004865
Provider Name (Legal Business Name): NICHOLAS J IZOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2017
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 PRINCETON AVENUE SW PROFESSIONAL OFFICE BLDG 2; SUITE 206
BIRMINGHAM AL
35211
US

IV. Provider business mailing address

1770 INDEPENDENCE CT
VESTAVIA HILLS AL
35216-1259
US

V. Phone/Fax

Practice location:
  • Phone: 205-226-5900
  • Fax: 205-226-5937
Mailing address:
  • Phone: 205-226-5900
  • Fax: 205-226-5937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number44368
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: