Organization
ORTHOPEDIC GROUP OF BIRMINGHAM,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ALAN ELKUS M.D. (PHYSICIAN)
(205) 939-0610
Entity
Organization
Contact information
Practice address
1400 SOUTH 19TH STREET, BIRMINGHAM, AL 35205
(205) 939-0610
(205) 930-9134
Mailing address
1400 SOUTH 19TH STREET, BIRMINGHAM, AL 35205
(205) 939-0610
(205) 930-9134
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
00024049
AL
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
00024049
AL
207XX0801X
Orthopaedic Trauma Physician
00024049
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51553670
BLUE CROSS- BLUE SHIELD
AL
05
—
EL009926035
—
AL
Enumeration date
12/05/2006
Last updated
04/07/2008
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