MEDICARE: MR. BRIAN CHARLES GOBER MAT, ATC, NREMT-P

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	146L00000X	Paramedic	9900084	AL
2	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1659301265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRIAN CHARLES GOBER MAT, ATC, NREMT-P

Provider Business Mailing Address
First Line	:	2481 MIKELL RD
Second Line	:
City	:	HAYDEN
State	:	AL
Zip	:	35079-9003
Country	:	US
Telephone Number	:	205-229-3287
Fax Number	:

Provider Business Practice Location Address
First Line	:	1670 VOLKER HALL
Second Line	:	L209 UNIVERSITY BLVD
City	:	BIRMINGHAM
State	:	AL
Zip	:	35294-0001
Country	:	US
Telephone Number	:	205-934-5870
Fax Number	:

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	09/11/2025

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