Healthcare Provider Details

I. General information

NPI: 1457811473
Provider Name (Legal Business Name): FARRUKH JAVED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 SPRING HILL AVE STE 100
MOBILE AL
36604-1416
US

IV. Provider business mailing address

1700 SPRING HILL AVE STE 100
MOBILE AL
36604-1416
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-1200
  • Fax: 251-435-6357
Mailing address:
  • Phone: 251-435-1200
  • Fax: 251-435-6357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number54619
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number51649
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: