Healthcare Provider Details

I. General information

NPI: 1174529689
Provider Name (Legal Business Name): JAMES M KAMPLAIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 12/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MONTCLAIR RD
BIRMINGHAM AL
35213-1908
US

IV. Provider business mailing address

2000A SOUTHBRIDGE PKWY STE 300
BIRMINGHAM AL
35209-7718
US

V. Phone/Fax

Practice location:
  • Phone: 205-592-1000
  • Fax:
Mailing address:
  • Phone: 205-871-4274
  • Fax: 205-871-4301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number7444
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: