Healthcare Provider Details

I. General information

NPI: 1780511162
Provider Name (Legal Business Name): CHASE KEILAN MAHLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 BROOKWOOD MEDICAL CTR DR
BIRMINGHAM AL
35209-6804
US

IV. Provider business mailing address

554 WHITE STONE WAY
HOOVER AL
35226-4214
US

V. Phone/Fax

Practice location:
  • Phone: 205-877-1000
  • Fax:
Mailing address:
  • Phone: 251-490-5574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: