Provider Demographics
NPI:1609841550
Name:KITCHENS, JERRY LESTER JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:LESTER
Last Name:KITCHENS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:806 SAINT VINCENTS DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1684
Mailing Address - Country:US
Mailing Address - Phone:205-930-8010
Mailing Address - Fax:205-263-0689
Practice Address - Street 1:806 SAINT VINCENTS DR
Practice Address - Street 2:SUITE 500
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1684
Practice Address - Country:US
Practice Address - Phone:205-930-8010
Practice Address - Fax:205-263-0689
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2013-04-29
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Provider Licenses
StateLicense IDTaxonomies
AL16460208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL84354Medicare PIN
ALE01395Medicare UPIN