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NPI Code Detail

MEDICARE: BROOKWOOD PRIMARY CARE VESTAVIA, L.L.C.

MEDICARE: BROOKWOOD PRIMARY CARE VESTAVIA, L.L.C.
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1225348527
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROOKWOOD PRIMARY CARE VESTAVIA, L.L.C.
Provider Business Mailing Address
First Line : 4902 VALLEYDALE RD
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35242-4613
Country : US
Telephone Number : 205-980-8099
Fax Number : 205-980-2606
Provider Business Practice Location Address
First Line : 2017 CANYON RD
Second Line : SUITE 39
City : VESTAVIA
State : AL
Zip : 35216-1900
Country : US
Telephone Number : 205-871-7746
Fax Number : 205-871-9234
Authorized Official
Title or Position : REGIONAL CFO, TENET
Name : MR. WESLEY O. JAMES
Credential :
Telephone Number : 404-265-5009
Provider Enumeration Date : 10/20/2010
Last Update Date : 05/26/2016

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Directions to “BROOKWOOD PRIMARY CARE VESTAVIA, L.L.C. ” Practice Location

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