| Rudolph Bolling Psychiatry Pc | |
|
201 Beacon Pkwy W Ste 201 Birmingham AL 35209-3129 | |
| (615) 828-1402 | |
| Not Available |
| Full Name | Rudolph Bolling Psychiatry Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 201 Beacon Pkwy W Ste 201, Birmingham, Alabama |
| Authorized Official Name and Position | Brandi J Rudolph Bolling (PSYCHIATRIST/ OWNER) |
| Authorized Official Contact | 6158281402 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rudolph Bolling Psychiatry Pc 201 Beacon Pkwy W Ste 201 Birmingham AL 35209-3129 Ph: () - | Rudolph Bolling Psychiatry Pc 201 Beacon Pkwy W Ste 201 Birmingham AL 35209-3129 Ph: (615) 828-1402 |
| NPI Number | 1902216203 |
|---|---|
| Provider Enumeration Date | 05/07/2014 |
| Last Update Date | 05/07/2014 |
| Medicare PECOS PAC ID | 9638539513 |
|---|---|
| Medicare Enrollment ID | O20230725000136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902216203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 30986 (Alabama) | Primary |
| Provider Name | Brandi J Rudolph Bolling |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962611616 PECOS PAC ID: 4789739673 Enrollment ID: I20110816000338 |
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