DR. JAN E MATHISEN M.D. NPI 1275687766

NPI Information

NPI: 1275687766
Provider Name: DR. JAN E MATHISEN, M.D.
Classification: Psychiatry & Neurology - 2084N0402X
Entity Type: Individual

Specialization: Neurology with Special Qualifications in Child Neurology

PECOS Registration: Yes

Address:
1940 ELMER J BISSELL RD
SUITE C
BIRMINGHAM, AL
ZIP 35243
Phone: (205) 638-5860
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DR. Jan E Mathisen, M.D. is a neurology with special qualifications in child neurology psychiatry neurology in Birmingham, AL with 42 years of experience. The provider is a Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. DR. Jan E Mathisen, M.D. NPI is 1275687766. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TULANE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1982

The provider's business location address is:

1940 ELMER J BISSELL RD
SUITE C
BIRMINGHAM, AL
ZIP 35243-941
Phone: (205) 638-5860
Fax: (205) 638-5879

The NPI 1275687766 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/22/2007 and was last updated on 3/21/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		11165	ALABAMA	No
2	2084N0402X	Psychiatry & Neurology	Neurology with Special Qualifications in Child Neurology	11165	ALABAMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8804680	MEDICAID	ALABAMA
2	18033	OTHER	ALABAMA	BLUE CROSS
3	C76764	MEDICARE UPIN	ALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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