Healthcare Provider Details

I. General information

NPI: 1942331863
Provider Name (Legal Business Name): BHC-PRINCETON PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 10/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BEACON PKWY W SUITE 330
BIRMINGHAM AL
35209-3102
US

IV. Provider business mailing address

701 PRINCETON AVE SW GESTETNER BUILDING 636
BIRMINGHAM AL
35211-1303
US

V. Phone/Fax

Practice location:
  • Phone: 205-715-5910
  • Fax: 205-715-5928
Mailing address:
  • Phone: 205-783-7871
  • Fax: 205-783-7876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLES A FAULKNER
Title or Position: PRESIDENT
Credential:
Phone: 205-715-5901