Individual
THOMAS A NOVACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-6600
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
464
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000070983
BLUE CROSS
AL
05
—
000070983
—
AL
05
—
009937585
—
AL
01
—
010033CH98021
SECTION 1011
AL
01
—
051517712
BLUE CROSS
AL
01
—
051534515
BC FEDERAL EHBP
AL
01
—
P00238782
RAILROAD MEDICARE
AL
01
—
R62409
VIVA
AL
Enumeration date
07/17/2006
Last updated
05/23/2010
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