Provider Demographics
NPI:1306310909
Name:INJURY SPECIALISTS OF BIRMINGHAM, LLC.
Entity type:Organization
Organization Name:INJURY SPECIALISTS OF BIRMINGHAM, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP-C
Authorized Official - Phone:205-425-5428
Mailing Address - Street 1:5031 FORD PKWY STE 112A
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-5283
Mailing Address - Country:US
Mailing Address - Phone:205-425-5428
Mailing Address - Fax:205-425-7590
Practice Address - Street 1:5031 FORD PKWY STE 112A
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-5283
Practice Address - Country:US
Practice Address - Phone:205-425-5428
Practice Address - Fax:205-425-7590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty