Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 01059939A | IN |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD.34402 | AL |
NPI | 1003094293 |
---|---|
Provider Name | Dr. Joseph Stephen Brigance |
First Address | Huntsville, AL 35801 |
Second Address | Huntsville, AL 35801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2008 |
Last Update Date | 09/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000631913 | ANTHEM PIN (01) | IN |
200952970 | (05) | IN |