Healthcare Provider Details

I. General information

NPI: 1538221882
Provider Name (Legal Business Name): DR. JAMES PAUL BERETTA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 MEADOWVIEW LANE SUITE 101
PELHAM AL
35124
US

IV. Provider business mailing address

2501 MEADOWVIEW LANE SUITE 101
PELHAM AL
35124
US

V. Phone/Fax

Practice location:
  • Phone: 205-685-5357
  • Fax: 205-685-5371
Mailing address:
  • Phone: 205-685-5357
  • Fax: 205-685-5371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD0289
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberDO289
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberDO289
License Number StateAL

VIII. Authorized Official

Name: DR. JAMES PAUL BERETTA
Title or Position: OWNER
Credential: M.D, D.O.,
Phone: 205-685-5357