Provider Demographics
| NPI: | 1013028380 |
|---|---|
| Name: | MULROONEY, BRIAN CHRISTOPHER (MD) |
| Entity Type: | Individual |
| Prefix: | DR |
| First Name: | BRIAN |
| Middle Name: | CHRISTOPHER |
| Last Name: | MULROONEY |
| Suffix: | |
| Gender: | M |
| Credentials: | MD |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 200 WILDWOOD PKWY STE 100B |
| Mailing Address - Street 2: | |
| Mailing Address - City: | BIRMINGHAM |
| Mailing Address - State: | AL |
| Mailing Address - Zip Code: | 35209-7300 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 205-943-4600 |
| Mailing Address - Fax: | 205-943-4688 |
| Practice Address - Street 1: | 1150 EAGLETREE LN SW |
| Practice Address - Street 2: | |
| Practice Address - City: | HUNTSVILLE |
| Practice Address - State: | AL |
| Practice Address - Zip Code: | 35801-6446 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 256-533-8801 |
| Practice Address - Fax: | 256-533-8803 |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2006-08-31 |
| Last Update Date: | 2024-03-04 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| AL | 00026244 | 207W00000X, 207W00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| AL | 515-47889 | Other | BC 201 PINE STREET NW, HARTSELLE |
| AL | 515-47895 | Other | BC ONE HOSPITAL DRIVE SE, HUNTSVILLE |
| AL | 515-47894 | Other | BC 721 MADISON STREET SE, HUNTSVILLE |
| AL | P00186101 | Other | RAILROAD MEDICARE |
| AL | 510-10133 | Other | BC 823 6TH AVENUE SE, DECATUR |
| AL | 510-10141 | Other | BC 1207 EAST FORREST STREET, SUITE H, ATHENS |
| AL | 1013028380 | Medicare PIN | |
| AL | 51525184 | Other | BLUE CROSS GADSDEN |
| TN | 3332010 | Other | CIGNA MEDICARE |
| AL | 7926043 | Other | AETNA INSURANCE |
| AL | 7926043 | Other | AETNA |
| AL | 510-10116 | Other | BC 2349 DANVILLE ROAD SW, SUITE 410, DECATUR |
| AL | 051555201 | Medicare PIN | |
| H00405 | Medicare UPIN | ||
| TN | 3332010 | Medicare PIN | |
| AL | 515-47893 | Other | BC 460 LANIER ROAD, MADISON |
| AL | 515-25095 | Other | BC 1150 EAGLETREE LANE SE, HUNTSVILLE |
| AL | 515-47888 | Other | BC 1874 BELTLINE ROAD, DECATUR |
| AL | 1013028280 | Medicaid | |
| AL | 515-47892 | Other | BC 2828 HIGHWAY 31 SOUTH, DECATUR |
| AL | 515-47887 | Other | BC 101 SIVLEY ROAD, HUNTSVILLE |
| TN | 3730605 | Medicaid | |
| TN | 3332010 | Medicaid | |
| AL | 051555201 | Medicaid | |
| AL | 1013028380 | Medicaid |
