Healthcare Provider Details

I. General information

NPI: 1740814441
Provider Name (Legal Business Name): CASSIDY DAWN QUIMBY PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2020
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 INDEPENDENCE PLAZA SUITE 900
BIRMINGHAM AL
35209-2643
US

IV. Provider business mailing address

1 INDEPENDENCE PLAZA SUITE 900
BIRMINGHAM AL
35209-2643
US

V. Phone/Fax

Practice location:
  • Phone: 205-271-8000
  • Fax: 205-271-8050
Mailing address:
  • Phone: 205-271-8000
  • Fax: 205-271-8050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberPA.1586
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA1586
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: