Healthcare Provider Details

I. General information

NPI: 1972558831
Provider Name (Legal Business Name): BROOKWOOD INTERNAL MEDICINE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 06/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2017 CANYON ROAD SUITE # 39
BIRMINGHAM AL
35216-1928
US

IV. Provider business mailing address

2017 CANYON ROAD SUITE # 39
BIRMINGHAM AL
35216-1928
US

V. Phone/Fax

Practice location:
  • Phone: 205-871-7746
  • Fax: 205-871-9234
Mailing address:
  • Phone: 205-871-7746
  • Fax: 205-871-9234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CATHERINE C CROW II
Title or Position: ADMINISTRATOR
Credential:
Phone: 205-871-7746