Healthcare Provider Details

I. General information

NPI: 1114217452
Provider Name (Legal Business Name): AUSTIN MICHAEL KANE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 05/20/2021
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 6TH AVE S STE 9100
BIRMINGHAM AL
35233-1802
US

IV. Provider business mailing address

1700 6TH AVE S STE 9100
BIRMINGHAM AL
35233-1802
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-3460
  • Fax:
Mailing address:
  • Phone: 205-934-3460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD.38613
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberMD.38613
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: