Healthcare Provider Details

I. General information

NPI: 1578538112
Provider Name (Legal Business Name): EDWARD LYLE CAIN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 SAINT VINCENTS DR STE 100
BIRMINGHAM AL
35205-1636
US

IV. Provider business mailing address

805 SAINT VINCENTS DR STE 100
BIRMINGHAM AL
35205-1636
US

V. Phone/Fax

Practice location:
  • Phone: 205-939-3699
  • Fax: 205-484-2585
Mailing address:
  • Phone: 205-939-3699
  • Fax: 205-484-2585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD22442
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberMD22442
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: