Provider Demographics
NPI:1639942592
Name:UNIVERSITY OF ALABAMA AT BIRMINGHAM
Entity Type:Organization
Organization Name:UNIVERSITY OF ALABAMA AT BIRMINGHAM
Other - Org Name:UAB SCHOOL OF HEALTH PROFESSIONS CLINICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATE DEAN FOR CLINICAL AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-934-0475
Mailing Address - Street 1:1716 9TH AVE SOUTH 630B
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-1212
Mailing Address - Country:US
Mailing Address - Phone:205-934-0475
Mailing Address - Fax:
Practice Address - Street 1:1716 9TH AVE SOUTH 630B
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-1212
Practice Address - Country:US
Practice Address - Phone:205-934-0475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Single Specialty