Healthcare Provider Details

I. General information

NPI: 1528119518
Provider Name (Legal Business Name): JAMES C GROTTING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 INVERNESS CENTER PKWY SUITE 100
BIRMINGHAM AL
35242-4817
US

IV. Provider business mailing address

1 INVERNESS CENTER PKWY SUITE 100
BIRMINGHAM AL
35242-4817
US

V. Phone/Fax

Practice location:
  • Phone: 205-930-1600
  • Fax: 205-991-9521
Mailing address:
  • Phone: 205-930-1600
  • Fax: 205-991-9521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number12114
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: