Individual
DR. AUSTIN CLARK BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2006 FRANKLIN ST SE, SUITE 200, HUNTSVILLE, AL 35801-4551
(256) 539-0457
(256) 539-5827
Mailing address
2006 FRANKLIN ST SE STE 200, HUNTSVILLE, AL 35801-4537
(256) 539-0457
(256) 539-5827
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
34979
AL
2085R0204X
Vascular & Interventional Radiology Physician
55127
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13833658
CAQH
—
05
—
186258
—
AL
05
—
186259
—
AL
05
—
186261
—
AL
05
—
186421
—
AL
05
—
186919
—
AL
05
—
187937
—
AL
05
—
212140
—
AL
05
—
240050
—
AL
05
—
244137
—
AL
05
—
244139
—
AL
05
—
244356
—
AL
05
—
244622
—
AL
05
—
245294
—
AL
05
—
245583
—
AL
Enumeration date
05/03/2010
Last updated
02/26/2024
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