Provider Demographics
NPI:1710003694
Name:HEART AND ENDOCRINE CLINIC, P.C.
Entity Type:Organization
Organization Name:HEART AND ENDOCRINE CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAKASH
Authorized Official - Middle Name:C
Authorized Official - Last Name:KANSAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-822-6952
Mailing Address - Street 1:1344 PANORAMA DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-3013
Mailing Address - Country:US
Mailing Address - Phone:205-822-6952
Mailing Address - Fax:205-822-6952
Practice Address - Street 1:801 PRINCETON AVE SW
Practice Address - Street 2:POB 1, STE 332
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1310
Practice Address - Country:US
Practice Address - Phone:205-780-0084
Practice Address - Fax:205-780-0085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC73555Medicare UPIN