Healthcare Provider Details

I. General information

NPI: 1649368739
Provider Name (Legal Business Name): THORACIC AND CARDIO.SURGEONS,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 MONTCLAIR RD SUITE 380
BIRMINGHAM AL
35213-1972
US

IV. Provider business mailing address

880 MONTCLAIR RD SUITE 380
BIRMINGHAM AL
35213-1972
US

V. Phone/Fax

Practice location:
  • Phone: 205-599-2525
  • Fax:
Mailing address:
  • Phone: 205-599-2525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number00022637
License Number StateAL

VIII. Authorized Official

Name: RICHARD GITTER
Title or Position: PRESIDENT
Credential: MD
Phone: 205-599-2525