Healthcare Provider Details

I. General information

NPI: 1326388158
Provider Name (Legal Business Name): BAPTIST HEALTH CENTER PRINCETON CARDIOTHORACIC SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2013
Last Update Date: 04/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 PRINCETON AVE SW POB III; SUITE 200A
BIRMINGHAM AL
35211-1323
US

IV. Provider business mailing address

833 PRINCETON AVE SW POB III; SUITE 200A
BIRMINGHAM AL
35211-1323
US

V. Phone/Fax

Practice location:
  • Phone: 205-786-2776
  • Fax: 205-786-6227
Mailing address:
  • Phone: 205-786-2776
  • Fax: 205-786-6227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: VALETA D NEAL
Title or Position: PRESIDENT/CEO
Credential:
Phone: 205-715-5901