Healthcare Provider Details

I. General information

NPI: 1780982546
Provider Name (Legal Business Name): RICHARD A KASLOW M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2011
Last Update Date: 03/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1665 UNIVERSITY BLVD RYALS 220
BIRMINGHAM AL
35294
US

IV. Provider business mailing address

1665 UNIVERSITY BLVD RYALS 220
BIRMINGHAM AL
35294
US

V. Phone/Fax

Practice location:
  • Phone: 205-975-8698
  • Fax: 205-934-8665
Mailing address:
  • Phone: 205-975-8698
  • Fax: 205-934-8665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number20334
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number20334
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: