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General NPI Number Information
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NPI Number | 1730712571
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Entity Type | Individual
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Provider Name | EMILY FALLON HUMPHREYS PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/20/2020
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 3686 GRANDVIEW PKWY STE 530
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City | BIRMINGHAM
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State | AL
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Zip | 35243-3405
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Country | US
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Telephone | 205-591-8260
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Fax |
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Provider Business Mailing Address
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Address Line | 38 W MONTCREST DR
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City | MOUNTAIN BRK
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State | AL
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Zip | 35213-3024
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Country | US
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Telephone | 205-332-5273
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1582
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License Number State | AL
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