Provider Demographics
NPI:1922001643
Name:ERGLE, BRIAN KEITH (AUD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:KEITH
Last Name:ERGLE
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 CAHABA VALLEY PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-2216
Mailing Address - Country:US
Mailing Address - Phone:800-379-0309
Mailing Address - Fax:205-942-5627
Practice Address - Street 1:245 CAHABA VALLEY PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-2216
Practice Address - Country:US
Practice Address - Phone:800-379-0309
Practice Address - Fax:205-942-5627
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51486231H00000X
NC5652231H00000X
MSA2835231H00000X
AL817A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51007364OtherBCBS OF ALABAMA
AL7401171OtherAETNA
AL631209505OtherTRI-CARE
AL009815580Medicaid
AL000007364Medicare ID - Type Unspecified
AL7401171OtherAETNA