Basic Information
Provider Information
NPI: 1053389031
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COWLEY
FirstName: STEPHEN
MiddleName: PATRICK
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 720 MONTCLAIR RD
Address2: SUITE101
City: BIRMINGHAM
State: AL
PostalCode: 352131964
CountryCode: US
TelephoneNumber: 2053975200
FaxNumber: 2053975210
Practice Location
Address1: 720 MONTCLAIR RD
Address2: SUITE101
City: BIRMINGHAM
State: AL
PostalCode: 352131964
CountryCode: US
TelephoneNumber: 2053975200
FaxNumber: 2053975210
Other Information
ProviderEnumerationDate: 03/08/2006
LastUpdateDate: 03/09/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X8461ALY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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