Provider Demographics
NPI:1215093224
Name:ALABAMA PEDIATRIC PULMONARY
Entity type:Organization
Organization Name:ALABAMA PEDIATRIC PULMONARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BRASFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-776-8789
Mailing Address - Street 1:2660 10TH AVENUE SOUTH
Mailing Address - Street 2:STE 701
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1628
Mailing Address - Country:US
Mailing Address - Phone:205-776-8789
Mailing Address - Fax:205-776-8792
Practice Address - Street 1:2660 10TH AVENUE SOUTH
Practice Address - Street 2:STE 701
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1628
Practice Address - Country:US
Practice Address - Phone:205-776-8789
Practice Address - Fax:205-776-8792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL41302080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric PulmonologyGroup - Single Specialty