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General NPI Number Information
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NPI Number | 1124787262
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Entity Type | Individual
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Provider Name | JONATHAN PIOUS MBBS
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Gender | Male
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Dates
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Enumeration Date | 12/16/2021
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 2152 OLD SPRINGVILLE RD
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City | CENTER POINT
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State | AL
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Zip | 35215-4005
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Country | US
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Telephone | 205-838-6022
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Fax |
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Provider Business Mailing Address
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Address Line | 101 22ND AVE NE
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City | CENTER POINT
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State | AL
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Zip | 35215-4607
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Country | US
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Telephone | 651-350-4800
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | L.5577R
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License Number State | AL
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