Provider Demographics
NPI:1194135533
Name:GODZIK, JAKUB (MD)
Entity type:Individual
Prefix:
First Name:JAKUB
Middle Name:
Last Name:GODZIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 20TH STREET SOUTH
Mailing Address - Street 2:FOT 1030 DEPARTMENT OF NEUROSURGERY
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233
Mailing Address - Country:US
Mailing Address - Phone:205-996-3208
Mailing Address - Fax:
Practice Address - Street 1:510 20TH ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-2028
Practice Address - Country:US
Practice Address - Phone:205-996-3208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL42707207T00000X
ALMD.42797207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery