Individual
GARY WILSON ARCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
810 SAINT VINCENTS DR, BIRMINGHAM, AL 35205-1601
(205) 939-7855
Mailing address
2090 COLUMBIANA RD, SUITE 4400, BIRMINGHAM, AL 35216-2153
(205) 824-8000
(205) 824-8111
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
9933
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51013095
BLUE CROSS/BLUE SHIELD
AL
01
—
51521228
BLUE CROSS BLUE SHIELD
AL
Enumeration date
02/17/2006
Last updated
11/29/2007
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