Provider Demographics
NPI:1477661056
Name:ZENKO J HRYNKIW, MD, PC
Entity Type:Organization
Organization Name:ZENKO J HRYNKIW, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLEY
Authorized Official - Middle Name:W
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-591-3566
Mailing Address - Street 1:720 MONTCLAIR RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1964
Mailing Address - Country:US
Mailing Address - Phone:205-591-3566
Mailing Address - Fax:205-591-3567
Practice Address - Street 1:720 MONTCLAIR RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1964
Practice Address - Country:US
Practice Address - Phone:205-591-3566
Practice Address - Fax:205-591-3567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00011222207T00000X
AL00016988207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000017385Medicaid
AL009934598Medicaid
AL009941273Medicaid
AL000017385Medicaid
ALC74557Medicare UPIN
AL009934598Medicaid
AL051531430Medicare ID - Type Unspecified
AL009941273Medicaid