Healthcare Provider Details

I. General information

NPI: 1598792244
Provider Name (Legal Business Name): ENT & ALLERGY ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2018 BROOKWOOD MEDICAL CTR DR SUITE 110
BIRMINGHAM AL
35209-6898
US

IV. Provider business mailing address

2018 BROOKWOOD MEDICAL CTR DR SUITE 110
BIRMINGHAM AL
35209-6898
US

V. Phone/Fax

Practice location:
  • Phone: 205-877-2705
  • Fax: 205-877-2706
Mailing address:
  • Phone: 205-877-2705
  • Fax: 205-877-2706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. KRISTINA H. TORTORICI
Title or Position: OFFICE MANAGER
Credential:
Phone: 205-877-2705