Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 25947 | AL |
NPI | 1023083946 |
---|---|
Provider Name | Dr. Charles Gerald Judy |
First Address | Huntsville, AL 35801-5126 |
Second Address | Huntsville, AL 35801-5126 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 26/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009951755 | (05) | AL |
051521002JUD | BKUE CROSS PROVIDER # (01) | AL |
E20946 | (02) |