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Individual

RICHARD ERVIN BIRMINGHAM II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
304 BAGWELL RD, KNOXVILLE, TN 37924-2813
(901) 674-1783
Mailing address
86065 SINATRA ST, YULEE, FL 32097-3908
(901) 674-1783

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3860
TN
363A00000X
Physician Assistant
9366
GA
363A00000X
Physician Assistant
Primary
PA9113895
FL
363A00000X
Physician Assistant

Other

Enumeration date
03/08/2019
Last updated
09/18/2022
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