Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 32442 | AL |
NPI | 1174788970 |
---|---|
Provider Name | Audra Woodruff Eason |
First Address | Birmingham, AL 35213-1923 |
Second Address | Birmingham, AL 35213-1923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2008 |
Last Update Date | 27/06/2013 |