Healthcare Provider Details

I. General information

NPI: 1780877936
Provider Name (Legal Business Name): KRISTIN TAYLOR BRUNSVOLD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4906 REYNOLDS LN
BIRMINGHAM AL
35242-7417
US

IV. Provider business mailing address

3144 CANTERBURY PL
VESTAVIA AL
35243-5260
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-6775
  • Fax: 205-838-6778
Mailing address:
  • Phone: 205-482-5214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number23403
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: