Individual
BRIAN RUSSELL INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1460A 2ND AVE SW, JACKSONVILLE, AL 36265-3358
(256) 435-2180
(256) 435-8718
Mailing address
4371 NARROW LANE RD STE 100, MONTGOMERY, AL 36116-2975
(334) 613-3680
(334) 613-3685
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO.2156
AL
Other
Enumeration date
08/15/2018
Last updated
08/30/2023
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