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General NPI Number Information
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NPI Number | 1487628111
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Entity Type | Individual
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Provider Name | RAINER A. BIRK M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/17/2006
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Last Update Date | 10/16/2014
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Provider Practice Location Address
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Address Line | 300 MEDICAL AVE SUITE 1
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City | ANDALUSIA
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State | AL
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Zip | 36420
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Country | US
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Telephone | 334-222-8734
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Fax | 334-222-8736
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Provider Business Mailing Address
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Address Line | PO BOX 1547 300 MEDICAL AVE STE 1
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City | ANDALUSIA
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State | AL
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Zip | 36420
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Country | US
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Telephone | 334-222-8734
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Fax | 334-222-8736
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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 | E2547
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License Number State | AR
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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 | E2547
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License Number State | AR
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