MEDICARE: BHC - HELENA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1053375154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BHC - HELENA

Provider Business Mailing Address
First Line	:	200 BEACON PKWY W
Second Line	:	SUITE 330
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-3153
Country	:	US
Telephone Number	:	205-715-5910
Fax Number	:	205-715-5928

Provider Business Practice Location Address
First Line	:	270 VILLAGE PKWY
Second Line	:
City	:	HELENA
State	:	AL
Zip	:	35080-4040
Country	:	US
Telephone Number	:	205-664-9430
Fax Number	:	205-664-1846

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERT DAVID KICKER
Credential	:
Telephone Number	:	205-715-5910

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	08/22/2020

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Directions to “BHC - HELENA ” Practice Location

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