Healthcare Provider Details
I. General information
NPI: 1932031432
Provider Name (Legal Business Name): BIRMINGHAM LONGEVITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1950 STONEGATE DR STE 315
VESTAVIA HLS AL
35242-2525
US
IV. Provider business mailing address
1950 STONEGATE DR STE 315
VESTAVIA HLS AL
35242-2525
US
V. Phone/Fax
- Phone: 205-936-1407
- Fax:
- Phone: 205-936-1407
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
MARK
HAND
JR.
Title or Position: COO
Credential:
Phone: 205-936-1407