Provider Demographics
NPI:1578548244
Name:CIMINO, JOHN P (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:CIMINO
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 1:1130 22ND ST S STE 1000
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2881
Mailing Address - Country:US
Mailing Address - Phone:205-715-5198
Mailing Address - Fax:
Practice Address - Street 1:47344 US HIGHWAY 78
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:AL
Practice Address - Zip Code:35096-6748
Practice Address - Country:US
Practice Address - Phone:256-763-7848
Practice Address - Fax:256-763-7235
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23304207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1749385Other1ST HEALTH/CCN
AL051516556Medicaid
AL51516556OtherBCBS OF AL
AL7313116OtherAETNA
AL051516556OtherMEDICARE
AL7410824OtherUNITED HEALTHCARE
AL051516556Medicaid
AL051516556Medicare ID - Type Unspecified