Healthcare Provider Details

I. General information

NPI: 1285698324
Provider Name (Legal Business Name): BHC - PINSON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 03/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4360 MAIN ST
PINSON AL
35126-3290
US

IV. Provider business mailing address

PO BOX 13128
BIRMINGHAM AL
35202-3128
US

V. Phone/Fax

Practice location:
  • Phone: 205-680-4836
  • Fax: 205-680-2235
Mailing address:
  • Phone: 205-715-5904
  • Fax: 205-715-5928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: G. SCOTT FENN
Title or Position: INTERIM PRESIDENT & CEO
Credential:
Phone: 205-715-5415