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General NPI Number Information
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NPI Number | 1104910280
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Entity Type | Organization
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Legal Business Name | JOHN R. KINGSLEY, MD, PC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 09/17/2014
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Provider Practice Location Address
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Address Line | 700 MONTGOMERY HWY SUITE 210
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City | VESTAVIA HILLS
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State | AL
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Zip | 35216-1866
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Country | US
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Telephone | 205-823-0151
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Fax | 205-823-5218
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Provider Business Mailing Address
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Address Line | 700 MONTGOMERY HWY SUITE 210
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City | VESTAVIA HILLS
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State | AL
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Zip | 35216-1866
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Country | US
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Telephone | 205-823-0151
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Fax | 205-823-5218
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MR. ZEKE ELDRIDGE
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Credential |
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Telephone | 205-823-0151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 5471
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License Number State | AL
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