Individual
MR. ANDREW JACKSON MYRICK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 W LAKESHORE DR STE 100, BIRMINGHAM, AL 35209-7271
(205) 930-2950
(205) 930-2957
Mailing address
1 W LAKESHORE DR STE 100, BIRMINGHAM, AL 35209-7271
(205) 930-2950
(205) 930-2957
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13729
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051039775
BLUE CROSS BLUE SHIELD
AL
Enumeration date
12/11/2006
Last updated
07/08/2007
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