Healthcare Provider Details

I. General information

NPI: 1093778706
Provider Name (Legal Business Name): RADIOLOGY ASSOCIATES OF BIRMINGHAM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 SAINT VINCENTS DR
BIRMINGHAM AL
35205-1601
US

IV. Provider business mailing address

2090 COLUMBIANA RD SUITE 4400
BIRMINGHAM AL
35216-2153
US

V. Phone/Fax

Practice location:
  • Phone: 205-824-8000
  • Fax: 205-824-8111
Mailing address:
  • Phone: 205-824-8000
  • Fax: 205-824-8111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY R NELSON
Title or Position: EXECUTIVE VICE-PRESIDENT
Credential:
Phone: 205-824-8108