Provider Demographics
NPI:1588645535
Name:KIRSCHBERG, GORDON J (MD)
Entity type:Individual
Prefix:
First Name:GORDON
Middle Name:J
Last Name:KIRSCHBERG
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:2018 BROOKWOOD MED CTR DR
Mailing Address - Street 2:ST 202
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6898
Mailing Address - Country:US
Mailing Address - Phone:205-879-4200
Mailing Address - Fax:205-870-7372
Practice Address - Street 1:2018 BROOKWOOD MED CTR DR
Practice Address - Street 2:ST 202
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6898
Practice Address - Country:US
Practice Address - Phone:205-879-4200
Practice Address - Fax:205-870-7372
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL00008096207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C74469Medicare UPIN