Healthcare Provider Details

I. General information

NPI: 1841375417
Provider Name (Legal Business Name): JEANNE M BIRKENHAUER, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 E 15TH AVE
GULF SHORES AL
36542-3516
US

IV. Provider business mailing address

156 E 15TH AVE
GULF SHORES AL
36542-3516
US

V. Phone/Fax

Practice location:
  • Phone: 251-948-4290
  • Fax: 251-948-7682
Mailing address:
  • Phone: 251-948-4290
  • Fax: 251-948-7682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JEANNE M BIRKENHAUER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 251-948-4290