Organization
EDWARDS LAKE MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKI BAILEY (BILLING MGR)
(205) 699-1632
Entity
Organization
Contact information
Practice address
3240 EDWARDS LAKE PKWY, SUITE 204, BIRMINGHAM, AL 35235-3117
(205) 949-1414
(205) 949-1415
Mailing address
3240 EDWARDS LAKE PKWY, SUITE 204, BIRMINGHAM, AL 35235-3117
(205) 949-1414
(205) 949-1415
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
00013482
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316985062
INDIVIDUAL NPI
AL
Enumeration date
08/31/2006
Last updated
06/20/2024
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