# UNIVERSITY OF ALABAMA AT BIRMINGHAM

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Other names:** UAB Department of Family Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063576858
- **Legal business name:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Authorized official:** MRS. TYRA JOHNSON-PIRTLE C.P.A (ADMINISTRATOR)
- **Authorized official phone:** (205) 934-1598

## Contact information

- **Practice address:** 930 20TH ST S, SUITE 325, BIRMINGHAM, AL 35205-2610
- **Practice address phone:** (205) 934-9700
- **Practice address fax:** (205) 975-6962
- **Mailing address:** 930 20TH ST S, SUITE 325, BIRMINGHAM, AL 35205-2610
- **Mailing address phone:** (205) 934-9700
- **Mailing address fax:** (205) 975-6962

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 12/19/2006
- **Last updated:** 04/20/2008