Healthcare Provider Details

I. General information

NPI: 1326571720
Provider Name (Legal Business Name): JOHN FORSTALL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2017
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 PRINCETON AVE SW STE 199
BIRMINGHAM AL
35211-1350
US

IV. Provider business mailing address

3500 BLUE LAKE DR STE 495
VESTAVIA AL
35243-1975
US

V. Phone/Fax

Practice location:
  • Phone: 205-780-1920
  • Fax: 205-780-2345
Mailing address:
  • Phone: 800-257-6570
  • Fax: 205-264-2053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberDO.4771
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberDO5216
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberDO5216
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: