1790769438 NPI number — MR. BARRY C GINSBURG MD

Table of content: MR. BARRY C GINSBURG MD (NPI 1790769438)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790769438 NPI number — MR. BARRY C GINSBURG MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GINSBURG
Provider First Name:
BARRY
Provider Middle Name:
C
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:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790769438
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/23/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
972 MONTCLAIR RD
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35213-1203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-592-4880
Provider Business Mailing Address Fax Number:
205-592-3999

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
972 MONTCLAIR RD
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-592-4880
Provider Business Practice Location Address Fax Number:
205-592-3999
Provider Enumeration Date:
12/06/2005

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: 207ND0101X , with the licence number:  00007430 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X , with the licence number: 00007430 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207N00000X , with the licence number: 00007430 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 252816 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: C71858 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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