Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 17363 | AL |
Y | 207RP1001X | Pulmonary Disease | 17363 | AL |
NPI | 1083634281 |
---|---|
Provider Name | Dr. Thomas Alan Vines |
First Address | Birmingham, AL 35235-3400 |
Second Address | Birmingham, AL 35235-3400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 17/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
51501662 | (05) | AL |
C76003 | (02) | AL |