Healthcare Provider Details

I. General information

NPI: 1548444383
Provider Name (Legal Business Name): EARL W. STRADTMAN JR., M/D. PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 10TH AVE S SUITE 201
BIRMINGHAM AL
35205-1200
US

IV. Provider business mailing address

2660 10TH AVE S SUITE 201
BIRMINGHAM AL
35205-1200
US

V. Phone/Fax

Practice location:
  • Phone: 205-933-5600
  • Fax: 205-933-5302
Mailing address:
  • Phone: 205-933-5600
  • Fax: 205-933-5302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EARL W STRADTMAN JR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 205-933-5600