Provider Demographics
NPI:1932133659
Name:KRELL, JAMES
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:KRELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1927 1ST AVE N STE 200
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-4050
Mailing Address - Country:US
Mailing Address - Phone:205-933-0987
Mailing Address - Fax:205-930-1758
Practice Address - Street 1:1927 1ST AVE N STE 200
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-4050
Practice Address - Country:US
Practice Address - Phone:205-933-0987
Practice Address - Fax:205-930-1758
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA33617207N00000X
AL17253207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL070006610OtherRAILROAD MEDICARE
AL510-88845OtherBCBS OF AL
AL51088845Medicare ID - Type Unspecified