Healthcare Provider Details

I. General information

NPI: 1871001404
Provider Name (Legal Business Name): PAUL TOWER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2018
Last Update Date: 01/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MEDICAL PARK DR E
BIRMINGHAM AL
35235-3401
US

IV. Provider business mailing address

5441 10TH CT S
BIRMINGHAM AL
35222-4015
US

V. Phone/Fax

Practice location:
  • Phone: 205-848-2925
  • Fax: 334-377-4417
Mailing address:
  • Phone: 205-441-3790
  • Fax: 334-377-4417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1-137833
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: