Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 25037 | AL |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 057882 | GA |
NPI | 1447227830 |
---|---|
Provider Name | Mr. Kristopher Frank Lay |
First Address | Birmingham, AL 35242-6402 |
Second Address | Birmingham, AL 35242-6402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2006 |
Last Update Date | 20/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051517678 | BLUE CROSS BLUE SHIELD (01) | AL |
H94780 | (02) | |
P00084134 | RAILROAD MEDICARE (01) | AL |