Individual provider · Type 1 NPI

Ethan Avery

Student in an Organized Health Care Education/Training Program · Birmingham, AL

NPI number 1225935612 Active

Practice location

800 Lakeshore Dr
Birmingham, AL 35229-0002

Call (205) 726-4883 Map

Mailing address

4 Crestview Ln SE
Rome, GA 30161-6277

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XS15079 (AL)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1225935612

Ethan Avery's National Provider Identifier is 1225935612, issued on Oct 20, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Birmingham, AL. The record was last updated on Oct 20, 2026.