Doctor Name: | REBEKAH ELISE HEAD |
NPI Number: | 1184986218 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A. |
License Number: | PA819 |
Business Practice Address: | 521 Montgomery Hwy Ste 117 Vestavia, AL - 352161878 |
Business Phone Number: | 2058244441 |
Business Fax Number: | 2058223978 |
Mailing Address: | 521 Montgomery Hwy, Ste 117 VESTAVIA |
State: | AL |
Postal Code: | 352161878 |
Phone Number: | 2058244441 |
Fax Number: | 2058223978 |
NPI Enumeration Date: | 06/14/2012 |
NPI Last Update Date: | 06/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | PA819 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |