Healthcare Provider Details

I. General information

NPI: 1679009302
Provider Name (Legal Business Name): JAMES WEST IV M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 PRINCETON AVE SW POB II, SUITE 106
BIRMINGHAM AL
35211-1333
US

IV. Provider business mailing address

817 PRINCETON AVE SW POB II, SUITE 106
BIRMINGHAM AL
35211-1333
US

V. Phone/Fax

Practice location:
  • Phone: 205-783-3191
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD485746
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: