1548202955 NPI number — DR. PAUL PULLEN SALTER III MD

Table of content: DR. PAUL PULLEN SALTER III MD (NPI 1548202955)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548202955 NPI number — DR. PAUL PULLEN SALTER III MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALTER
Provider First Name:
PAUL
Provider Middle Name:
PULLEN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
III
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:
1548202955
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/11/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 55361
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35255-5361
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-933-6440
Provider Business Mailing Address Fax Number:
205-933-6442

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 ST VINCENTS DRIVE
Provider Second Line Business Practice Location Address:
SUITE 510
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35205-1628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-933-6440
Provider Business Practice Location Address Fax Number:
205-933-6442
Provider Enumeration Date:
06/11/2006

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: 208600000X , with the licence number:  6779 , 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: 051017883SAL . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1710199 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".




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