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General NPI Number Information
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NPI Number | 1770519001
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Entity Type | Organization
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Legal Business Name | BROOKWOOD WOMENS DIAGNOSTIC CENTER, LLC
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 2006 MEDICAL CENTER DR STE 112
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City | BIRMINGHAM
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State | AL
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Zip | 35209-6823
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Country | US
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Telephone | 205-877-1000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 740799
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City | ATLANTA
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State | GA
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Zip | 30374-0799
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Country | US
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Telephone | 205-877-2453
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Fax | 205-871-0534
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Authorized Official
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Title or Position | OFFICER/AUTHORIZED OFFICIAL
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Name | ANGELA GILBERT
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Credential |
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Telephone | 214-236-8249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 11009
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License Number State | AL
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