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General NPI Number Information
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NPI Number | 1710038476
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Entity Type | Organization
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Legal Business Name | BIRMINGHAM PAIN CENTER INC.
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 4515 SOUTHLAKE PKWY STE 200
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City | HOOVER
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State | AL
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Zip | 35244-3319
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Country | US
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Telephone | 205-313-7246
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Fax | 205-939-1911
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Provider Business Mailing Address
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Address Line | 4515 SOUTHLAKE PKWY STE 200
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City | HOOVER
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State | AL
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Zip | 35244-3319
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Country | US
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Telephone | 205-313-7246
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Fax | 205-939-1911
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LUCY GIBSON
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Credential |
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Telephone | 205-313-7252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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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 | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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