Provider Demographics
NPI:1194020024
Name:WESTFALL PSYCHIATRIC SERVICES PC
Entity Type:Organization
Organization Name:WESTFALL PSYCHIATRIC SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:WESTFALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-623-2171
Mailing Address - Street 1:1 INDEPENDENCE PLZ
Mailing Address - Street 2:STE 325
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2629
Mailing Address - Country:US
Mailing Address - Phone:205-623-2171
Mailing Address - Fax:205-414-7030
Practice Address - Street 1:1 INDEPENDENCE PLZ
Practice Address - Street 2:SUITE 325
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-2629
Practice Address - Country:US
Practice Address - Phone:205-623-2171
Practice Address - Fax:205-414-7030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL200872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty