Healthcare Provider Details

I. General information

NPI: 1053375154
Provider Name (Legal Business Name): BHC - HELENA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 VILLAGE PKWY
HELENA AL
35080-4040
US

IV. Provider business mailing address

200 BEACON PKWY W SUITE 330
BIRMINGHAM AL
35209-3153
US

V. Phone/Fax

Practice location:
  • Phone: 205-664-9430
  • Fax: 205-664-1846
Mailing address:
  • Phone: 205-715-5910
  • Fax: 205-715-5928

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: ROBERT DAVID KICKER
Title or Position: PRESIDENT
Credential:
Phone: 205-715-5910