Provider Demographics
NPI:1336354547
Name:QUINNEY, BRENTON (MD)
Entity Type:Individual
Prefix:
First Name:BRENTON
Middle Name:
Last Name:QUINNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266010TH AVE S
Mailing Address - Street 2:POB 1 STE 608
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2018 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:SUITE 214
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6898
Practice Address - Country:US
Practice Address - Phone:205-939-3495
Practice Address - Fax:205-939-3495
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27182208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL130684Medicaid
AL208500240OtherAETNA
AL5890672OtherCIGNA