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General NPI Number Information
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NPI Number | 1023111820
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Entity Type | Individual
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Provider Name | KEVIN C. STAUDINGER M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 833 PRINCETON AVE SW POB II; SUITE 150
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City | BIRMINGHAM
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State | AL
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Zip | 35211-1323
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Country | US
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Telephone | 205-781-2699
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Fax | 205-781-2690
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Provider Business Mailing Address
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Address Line | 200 BEACON PKWY W SUITE 330
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City | BIRMINGHAM
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State | AL
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Zip | 35209-3102
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Country | US
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Telephone | 205-715-5910
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Fax | 205-715-5928
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 18848
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License Number State | AL
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