MR. SAMUEL O. S. IRVINE PA-C NPI 1376590059

NPI Information

NPI: 1376590059
Provider Name: MR. SAMUEL O. S. IRVINE, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
2871 ACTON ROAD
SUITE 100
BIRMINGHAM, AL
ZIP 35243
Phone: (205) 939-0023
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MR. Samuel O. S. Irvine, PA-C is a surgical physician assistant in Birmingham, AL. MR. Samuel O. S. Irvine, PA-C NPI is 1376590059. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2871 ACTON ROAD
SUITE 100
BIRMINGHAM, AL
ZIP 35243-560
Phone: (205) 939-0023
Fax: (205) 939-4180

The NPI 1376590059 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 5/28/2006 and was last updated on 5/27/2011.

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	363AS0400X	Physician Assistant	Surgical	PA-189	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	051001143	OTHER	ALABAMA	BLUE CROSS - 860 MONT RD
2	051001308	OTHER	ALABAMA	BLUE CROSS - 2660 10TH AV
3	051555846	MEDICARE PIN	ALABAMA
4	009989995	MEDICAID	ALABAMA
5	009934027	MEDICAID	ALABAMA
6	051001307	OTHER	ALABAMA	BLUE CROSS - 48 MED PARK
7	P35188	MEDICARE UPIN
8	009989985	MEDICAID	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: 11/14/2023

NPI Synchronization or Removal

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