Healthcare Provider Details

I. General information

NPI: 1659581551
Provider Name (Legal Business Name): CHAD E AUSTIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 10/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 MONTCLAIR RD 955
BIRMINGHAM AL
35213-1923
US

IV. Provider business mailing address

860 MONTCLAIR RD 955
BIRMINGHAM AL
35213-1923
US

V. Phone/Fax

Practice location:
  • Phone: 205-332-3160
  • Fax: 866-702-0880
Mailing address:
  • Phone: 205-332-3160
  • Fax: 866-702-0880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number7222871-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number27611
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number26711
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: