1033260880 NPI number — SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C.

Table of content: (NPI 1033260880)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033260880 NPI number — SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BAPTIST SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C.
Provider Other Organization Name Type Code:
4
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:
1033260880
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/17/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
880 MONTCLAIR RD
Provider Second Line Business Mailing Address:
SUITE 577
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35213-1972
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-595-6757
Provider Business Mailing Address Fax Number:
205-595-0472

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
880 MONTCLAIR RD
Provider Second Line Business Practice Location Address:
SUITE 577
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35213-1972
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-595-6757
Provider Business Practice Location Address Fax Number:
205-595-0472
Provider Enumeration Date:
01/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PHILLIPS
Authorized Official First Name:
MANDY
Authorized Official Middle Name:
Authorized Official Title or Position:
BUSINESS MANAGER
Authorized Official Telephone Number:
205-595-6757

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1992856801 . This is a "JEREMY BURKETT'S NPI#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1740252444 . This is a "CHERIE MINER'S NPI#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1821285917 . This is a "KEVIN BARBERIO'S NPI#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: I580 . This is a "MEDICARE GROUP LEGACY#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1104947712 . This is a "AMANDA MCANNALLY'S NPI#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1366414096 . This is a "ELIZABETH SWEAT'S NPI#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1427020122 . This is a "SAMUEL GOLDSTEIN'S NPI#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1558412478 . This is a "JASON DAVIDSON'S NPI#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1881666592 . This is a "RENEE RILEY'S NPI#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1003967944 . This is a "TROY STEWART'S NPI#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1134179245 . This is a "EVE SANTIAGO'S NPI#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1558512582 . This is a "MARCUS JEFFERSON'S NPI#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1831132083 . This is a "DR. CASEY'S NPI" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1972576304 . This is a "JAMES FLANAGAN'S NPI#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1235380270 . This is a "JENNY HARTZ'S NPI#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1912171513 . This is a "MARY E BUTT'S NPI#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1427020155 . This is a "DENISE GOLDSTEIN'S NPI#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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