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General NPI Number Information
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NPI Number | 1346970456
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Entity Type | Individual
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Provider Name | VITALII IAKOVLIEV MD
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Gender | Male
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Dates
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Enumeration Date | 06/13/2022
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 501 EMERY DR W
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City | HOOVER
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State | AL
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Zip | 35244-4625
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Country | US
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Telephone | 205-989-7254
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Fax | 205-989-4202
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Provider Business Mailing Address
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Address Line | PO BOX 55310
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City | BIRMINGHAM
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State | AL
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Zip | 35255-5310
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 50001
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License Number State | AL
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