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General NPI Number Information
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NPI Number | 1891949004
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Entity Type | Organization
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Legal Business Name | BHC-WALKER GASTROENTEROLGOY
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Dates
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Enumeration Date | 11/14/2008
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Last Update Date | 11/14/2008
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Provider Practice Location Address
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Address Line | 3400 HIGHWAY 78 E SUITE 406
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City | JASPER
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State | AL
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Zip | 35501-8907
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Country | US
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Telephone | 205-384-4212
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Fax |
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Provider Business Mailing Address
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Address Line | 200 BEACON PKWY W SUITE 330
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City | BIRMINGHAM
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State | AL
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Zip | 35209-3102
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | INTERIM PRESIDENT & CEO
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Name | JOHN M. BLACKBURN
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Credential |
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Telephone | 205-715-5901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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