Healthcare Provider Details

I. General information

NPI: 1184315228
Provider Name (Legal Business Name): ST. VINCENT'S ORTHOPEDICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2023
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 10TH AVE S STE 200
BIRMINGHAM AL
35205-1248
US

IV. Provider business mailing address

2700 10TH AVE S STE 200
BIRMINGHAM AL
35205-1248
US

V. Phone/Fax

Practice location:
  • Phone: 205-933-7838
  • Fax: 205-933-0951
Mailing address:
  • Phone: 205-933-7838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM F FAULL
Title or Position: CEO
Credential:
Phone: 205-933-7838