Provider Demographics
NPI:1770647794
Name:ALLERGY AND ASTHMA CENTER OF BIRMINGHAM
Entity Type:Organization
Organization Name:ALLERGY AND ASTHMA CENTER OF BIRMINGHAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSANN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-995-9941
Mailing Address - Street 1:1200 PROVIDENCE PARK
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4695
Mailing Address - Country:US
Mailing Address - Phone:205-995-9941
Mailing Address - Fax:205-995-8988
Practice Address - Street 1:1200 PROVIDENCE PARK
Practice Address - Street 2:SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-4695
Practice Address - Country:US
Practice Address - Phone:205-995-9941
Practice Address - Fax:205-995-8988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00026694174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL7042511OtherAETNA
AL51530682OtherBLUE CROSS AND BLUE SHIEL
AL7042511OtherAETNA