Healthcare Provider Details

I. General information

NPI: 1790365757
Provider Name (Legal Business Name): GARRISON COLE VEAZEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

443 MEADOW CROFT DR
BIRMINGHAM AL
35242-5439
US

IV. Provider business mailing address

2055 NORMANDIE DR STE 108
MONTGOMERY AL
36111-2730
US

V. Phone/Fax

Practice location:
  • Phone: 205-937-3045
  • Fax:
Mailing address:
  • Phone: 334-288-4624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number45145
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: