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General NPI Number Information
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NPI Number | 1992812606
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Entity Type | Individual
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Provider Name | STUART CARL TIESZEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 2018 BROOKWOOD MEDICAL CTR DR POB #311
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City | BIRMINGHAM
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State | AL
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Zip | 35209-6898
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Country | US
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Telephone | 205-329-7808
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Fax | 205-329-7807
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Provider Business Mailing Address
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Address Line | 2018 BROOKWOOD MEDICAL CTR DR POB #311
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City | BIRMINGHAM
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State | AL
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Zip | 35209-6898
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Country | US
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Telephone | 205-329-7805
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Fax | 205-329-7806
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 00012918
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 00012918
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License Number State | AL
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