Provider Demographics
NPI:1508872235
Name:BARLOTTA, KEVIN S (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:S
Last Name:BARLOTTA
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:PO BOX 11407 DRAWER 624
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35249-0624
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1806 SIXTH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35249-0001
Practice Address - Country:US
Practice Address - Phone:205-975-7387
Practice Address - Fax:205-975-4662
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27488207P00000X
ALMD.27488207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010187541Medicaid
AL009912167Medicaid
AL1508872235OtherTRICARE SOUTH
AL051536291Medicaid
AL515-41327OtherBCBS
AL515-36291OtherBCBS
AL051536291Medicare PIN
AL1508872235OtherTRICARE SOUTH
AL009912167Medicaid
AL051536291Medicaid
ALP00637964Medicare PIN
ALI39637Medicare UPIN