Provider Demographics
NPI:1275737876
Name:PEARSON, JANE (M D)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:PEARSON
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 10TH AVE S
Mailing Address - Street 2:STE. 520
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1605
Mailing Address - Country:US
Mailing Address - Phone:205-939-0196
Mailing Address - Fax:
Practice Address - Street 1:2660 10TH AVE S
Practice Address - Street 2:STE. 520
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1605
Practice Address - Country:US
Practice Address - Phone:205-939-0196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL41812084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000044910Medicaid
AL44910OtherBLUE CROSS
DG4010OtherRAILROAD MEDICARE GROUP
ALP12023034OtherMULTIPLAN HEALTH EOS
AL408013720OtherRAILROAD MEDICARE
AL4282422OtherAETNA
AL0510008OtherUNITED HEALTHCARE
AL408013720OtherRAILROAD MEDICARE
AL000044910Medicaid
AL44910OtherBLUE CROSS
AL0510008OtherUNITED HEALTHCARE