Healthcare Provider Details

I. General information

NPI: 1851698310
Provider Name (Legal Business Name): VINCENTIAN PHYSICIAN SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2011
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 SAINT VINCENT'S DRIVE 3RD FLOOR; PHYSICIAN DEVELOPMENT DEPT
BIRMINGHAM AL
35205-1601
US

IV. Provider business mailing address

PO BOX 55309
BIRMINGHAM AL
35255-5309
US

V. Phone/Fax

Practice location:
  • Phone: 205-930-2346
  • Fax: 205-930-2158
Mailing address:
  • Phone: 205-939-2900
  • Fax: 877-575-1089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KYLE HUPACH
Title or Position: VP REVENUE CYCLE
Credential:
Phone: 205-731-9287