1447227830 NPI number — MR. KRISTOPHER FRANK LAY MD

Table of content: MR. KRISTOPHER FRANK LAY MD (NPI 1447227830)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447227830 NPI number — MR. KRISTOPHER FRANK LAY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAY
Provider First Name:
KRISTOPHER
Provider Middle Name:
FRANK
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LAY
Provider Other First Name:
KRISTOPHER
Provider Other Middle Name:
FRANK
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1447227830
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7191 CAHABA VALLEY RD
Provider Second Line Business Mailing Address:
SUITE 301
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35242-6402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-980-2091
Provider Business Mailing Address Fax Number:
205-980-2196

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7191 CAHABA VALLEY RD
Provider Second Line Business Practice Location Address:
SUITE 301
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35242-6402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-980-2091
Provider Business Practice Location Address Fax Number:
205-980-2196
Provider Enumeration Date:
03/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207YX0905X , with the licence number:  057882 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Y00000X , with the licence number: 25037 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00084134 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 051517678 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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