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General NPI Number Information
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NPI Number | 1700873825
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Entity Type | Individual
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Provider Name | DONALD R CORNELIUS MD
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Gender | Male
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 1 INDEPENDENCE PLZ STE 600
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City | HOMEWOOD
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State | AL
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Zip | 35209-2659
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Country | US
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Telephone | 205-709-1337
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Fax | 205-267-0220
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Provider Business Mailing Address
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Address Line | 1 INDEPENDENCE PLZ STE 600
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City | HOMEWOOD
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State | AL
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Zip | 35209-2659
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Country | US
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Telephone | 205-709-1337
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Fax | 205-267-0220
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 00007394
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD.7394
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License Number State | AL
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