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General NPI Number Information
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NPI Number | 1730835513
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Entity Type | Individual
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Provider Name | MOLLY CATHERINE BURCHELL PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/01/2022
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Last Update Date | 03/01/2022
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Provider Practice Location Address
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Address Line | 810 SAINT VINCENTS DR
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City | BIRMINGHAM
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State | AL
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Zip | 35205-1601
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Country | US
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Telephone | 205-237-0167
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Fax |
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Provider Business Mailing Address
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Address Line | 383 LAUREL CREEK DR
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City | LEEDS
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State | AL
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Zip | 35094-6033
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Country | US
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Telephone | 205-317-2482
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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 | 1917
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License Number State | AL
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