Healthcare Provider Details

I. General information

NPI: 1588640536
Provider Name (Legal Business Name): MARION SOVIC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 BROOKWOOD BLVD STE 101
HOMEWOOD AL
35209-6878
US

IV. Provider business mailing address

2270 VALLEYDALE RD STE 200
HOOVER AL
35244-2101
US

V. Phone/Fax

Practice location:
  • Phone: 205-682-6056
  • Fax: 205-682-6057
Mailing address:
  • Phone: 205-682-6056
  • Fax: 205-682-6057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number19417
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: