Individual
MR. JONATHAN PETER SOUTHWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1 WEST LAKESHORE DRIVE, SUITE 100, BIRMINGHAM, AL 35209-7271
(205) 930-2950
(205) 930-2957
Mailing address
1 WEST LAKESHORE DRIVE, SUITE 100, BIRMINGHAM, AL 35209-7271
(205) 930-2950
(205) 930-2957
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO780
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000060008
—
AL
05
—
051555035
—
AL
Enumeration date
02/06/2006
Last updated
08/22/2014
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