Organization
OUTPATIENT SERVICES EAST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES EDWARD STIDHAM (PRES CEO)
(205) 838-3888
Entity
Organization
Contact information
Practice address
52 MEDICAL PARK DRIVE EAST, SUITE 401, BIRMINGHAM, AL 35235
(205) 838-3888
(205) 838-3875
Mailing address
52 MEDICAL PARK DRIVE EAST, SUITE 401, BIRMINGHAM, AL 35235
(205) 838-3888
(205) 838-3875
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
311
BLUE CROSS
AL
05
—
ASC0006C
—
AL
Enumeration date
10/12/2006
Last updated
08/22/2020
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