Healthcare Provider Details

I. General information

NPI: 1629205182
Provider Name (Legal Business Name): JOSEPH E BORNSTEIN MD, MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2009
Last Update Date: 02/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 AIRPORT BLVD STE A208
MOBILE AL
36608-3763
US

IV. Provider business mailing address

6701 AIRPORT BLVD STE D143
MOBILE AL
36608-6701
US

V. Phone/Fax

Practice location:
  • Phone: 251-633-1981
  • Fax: 251-631-3298
Mailing address:
  • Phone: 251-342-3949
  • Fax: 251-266-3361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number272632
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberL-239969
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD.34455
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: