Healthcare Provider Details

I. General information

NPI: 1457097255
Provider Name (Legal Business Name): COMPREHENSIVE BREAST HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2022
Last Update Date: 05/05/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 INDEPENDENCE PLZ STE 100
BIRMINGHAM AL
35209-2629
US

IV. Provider business mailing address

1 INDEPENDENCE PLZ STE 100
BIRMINGHAM AL
35209-2629
US

V. Phone/Fax

Practice location:
  • Phone: 205-544-3141
  • Fax: 205-544-3152
Mailing address:
  • Phone: 205-544-3141
  • Fax: 205-544-3152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANNA M KNIGHT
Title or Position: OWNER
Credential: MD
Phone: 205-544-3141