Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 35968 | AL |
NPI | 1063709624 |
---|---|
Provider Name | Kyle William Eudailey |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35249-1303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2011 |
Last Update Date | 10/09/2020 |