Organization
KENNETH MARK MIDDLEBROOKS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM YORK (BILLING AND CREDENTIALING)
(205) 854-1111
Entity
Organization
Contact information
Practice address
100 PILOT MEDICAL DRIVE, SUITE 125, BIRMINGHAM, AL 35235-3430
(205) 380-0848
Mailing address
100 PILOT MEDICAL DRIVE, SUITE 125, BIRMINGHAM, AL 35235-3430
(205) 380-0848
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
207RI0200X
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000089762
—
AL
01
—
1891742706
INDIVIDUAL NPI
AL
Enumeration date
08/11/2006
Last updated
06/20/2024
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