Organization
ORTHOPEDIC & SPORTSMEDICINE SPECIALISTS OF CULLMAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT F BERGQUIST JR. MD (PRESIDENT)
(256) 739-4030
Entity
Organization
Contact information
Practice address
1938 AL HIGHWAY 157, SUITE 101, CULLMAN, AL 35058-0609
(256) 739-4030
(256) 739-5743
Mailing address
1938 AL HIGHWAY 157, SUITE 101, CULLMAN, AL 35058-0609
(256) 739-4030
(256) 739-5743
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
00027474
AL
207X00000X
Orthopaedic Surgery Physician
14798
AL
207X00000X
Orthopaedic Surgery Physician
Primary
6543
AL
213E00000X
Podiatrist
173
AL
213E00000X
Podiatrist
191
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528300730
—
AL
Enumeration date
07/26/2006
Last updated
04/24/2015
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