Individual
BEN E EZELLE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
619 19TH ST S, BIRMINGHAM, AL 35249-7010
(205) 934-4011
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
1-159608
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
AL
Other
Enumeration date
06/28/2021
Last updated
08/22/2023
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