Individual
MS. ANDREA MOORE JOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
4517 SOUTHLAKE PKWY, SUITE 202, BIRMINGHAM, AL 35244-3280
(205) 985-4111
(205) 985-4326
Mailing address
PO BOX 830791, BIRMINGHAM, AL 35283-0791
(205) 985-4111
(205) 985-4326
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-482
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051536228
—
AL
01
—
PA-482
STATE LICENSE
AL
01
—
TA-1605
STATE LICENSE NUMBER
AL
Enumeration date
09/02/2006
Last updated
01/13/2014
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