Provider Demographics
NPI:1578538112
Name:CAIN, EDWARD LYLE JR (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:LYLE
Last Name:CAIN
Suffix:JR
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 1:805 SAINT VINCENTS DR
Mailing Address - Street 2:STE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1636
Mailing Address - Country:US
Mailing Address - Phone:205-939-3699
Mailing Address - Fax:205-930-0008
Practice Address - Street 1:805 SAINT VINCENTS DR
Practice Address - Street 2:STE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1636
Practice Address - Country:US
Practice Address - Phone:205-939-3699
Practice Address - Fax:205-930-0008
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD22442207XX0005X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51174131OtherBLUE CROSS
AL189726Medicaid
AL051559053Medicare PIN
AL051559053Medicaid
G36420Medicare UPIN