Healthcare Provider Details

I. General information

NPI: 1013610278
Provider Name (Legal Business Name): VICTORIA ELIZABETH DEAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 SUTTON RD SE
OWENS CROSS ROADS AL
35763-8753
US

IV. Provider business mailing address

625 19TH ST S
BIRMINGHAM AL
35233-1900
US

V. Phone/Fax

Practice location:
  • Phone: 256-265-0350
  • Fax: 256-265-0357
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO.3794
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: