MEDICARE: B VITALITY PLLC

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	208D00000X	General Practice Physician	17022747	AL

General Provider Information

NPI Number	:	1558898874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	B VITALITY PLLC

Provider Business Mailing Address
First Line	:	PO BOX 242848
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36124-2848
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3425 COLONNADE PKWY STE C
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35243-2356
Country	:	US
Telephone Number	:	205-588-6700
Fax Number	:	205-449-4959

Authorized Official
Title or Position	:	M.D./OWNER
Name	:	DR. ROSS BARNETT
Credential	:	M.D.
Telephone Number	:	205-588-6700

Provider Enumeration Date	:	05/17/2017
Last Update Date	:	05/17/2017

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