Healthcare Provider Details

I. General information

NPI: 1841244886
Provider Name (Legal Business Name): VASCULAR ASSOCIATES OF BIRMINGHAM, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 PRINCETON AVE SW SUITE 306
BIRMINGHAM AL
35211-1333
US

IV. Provider business mailing address

817 PRINCETON AVE SW SUITE 306
BIRMINGHAM AL
35211-1333
US

V. Phone/Fax

Practice location:
  • Phone: 205-783-0160
  • Fax: 205-788-6249
Mailing address:
  • Phone: 205-783-0160
  • Fax: 205-788-6249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number00013686
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number00021035
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number00023846
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberTA-1645
License Number StateAL
# 5
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number00019081
License Number StateAL

VIII. Authorized Official

Name: DR. ROBERT SCOTT MCCORD
Title or Position: PRESIDENT/PHYSICIAN
Credential: MD
Phone: 205-783-0160