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General NPI Number Information
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NPI Number | 1093995623
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Entity Type | Individual
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Provider Name | PAUL JEFFREY RICKERT M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/12/2007
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Last Update Date | 05/12/2014
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Provider Practice Location Address
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Address Line | 1 CHASE CORPORATE DR SUITE 225
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City | HOOVER
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State | AL
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Zip | 35244-1026
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Country | US
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Telephone | 205-733-6033
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Fax | 205-733-6036
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Provider Business Mailing Address
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Address Line | 1 CHASE CORPORATE DR SUITE 225
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City | HOOVER
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State | AL
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Zip | 35244-1026
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Country | US
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Telephone | 205-733-6033
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Fax | 205-733-6036
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 27964
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 27964
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License Number State | AL
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