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General NPI Number Information
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NPI Number | 1902216203
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Entity Type | Organization
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Legal Business Name | RUDOLPH BOLLING PSYCHIATRY PC
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 05/07/2014
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Provider Practice Location Address
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Address Line | 201 BEACON PKWY W STE 201
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City | BIRMINGHAM
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State | AL
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Zip | 35209-3129
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Country | US
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Telephone | 615-828-1402
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Fax |
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Provider Business Mailing Address
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Address Line | 201 BEACON PKWY W STE 201
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City | BIRMINGHAM
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State | AL
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Zip | 35209-3129
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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 | PSYCHIATRIST/ OWNER
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Name | BRANDI J RUDOLPH BOLLING
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Credential | MD
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Telephone | 615-828-1402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 30986
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License Number State | AL
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