Healthcare Provider Details

I. General information

NPI: 1003094293
Provider Name (Legal Business Name): JOSEPH STEPHEN BRIGANCE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2008
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 WHITESPORT DRIVE
HUNTSVILLE AL
35801
US

IV. Provider business mailing address

201 WHITESPORT DRIVE
HUNTSVILLE AL
35801
US

V. Phone/Fax

Practice location:
  • Phone: 256-881-5353
  • Fax: 256-881-0712
Mailing address:
  • Phone: 256-881-5353
  • Fax: 256-881-0712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number01059939A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD.34402
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: