MEDICARE: DR. JOAN BLACK CAIN MD

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	207R00000X	Internal Medicine Physician	10162	AL

General Provider Information

NPI Number	:	1639430770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOAN BLACK CAIN MD

Provider Business Mailing Address
First Line	:	2936 REDMONT PARK LN
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-2136
Country	:	US
Telephone Number	:	205-322-3696
Fax Number	:	205-716-1215

Provider Business Practice Location Address
First Line	:	2936 REDMONT PARK LN
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-2136
Country	:	US
Telephone Number	:	205-322-3696
Fax Number	:	205-716-1215

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2012
Last Update Date	:	06/05/2012

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Directions to “ DR. JOAN BLACK CAIN MD” Practice Location

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