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General NPI Number Information
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NPI Number | 1922068774
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Entity Type | Organization
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Legal Business Name | BIRMINGHAM SURGICAL, P.C.
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 2022 BROOKWOOD MEDICAL CTR DR SUITE 313 ACC
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City | BIRMINGHAM
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State | AL
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Zip | 35209-6808
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Country | US
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Telephone | 205-877-2910
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Fax | 205-879-4649
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Provider Business Mailing Address
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Address Line | 2022 BROOKWOOD MEDICAL CTR DR SUITE 313 ACC
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City | BIRMINGHAM
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State | AL
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Zip | 35209-6808
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Country | US
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Telephone | 205-877-2910
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Fax | 205-879-4649
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. BRIAN DEREK LASKER
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Credential | MBA
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Telephone | 205-877-2910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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