Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 00025395 | AL |
Y | 208600000X | Surgeon | 00025395 | AL |
N | 2086S0102X | Surgical Critical Care | 00025395 | AL |
NPI | 1275521510 |
---|---|
Provider Name | Dr. Dennis Layson Fernandez |
First Address | Huntsville, AL 35801-7433 |
Second Address | Huntsville, AL 35801-7433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 14/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009935184 | (05) | AL |
051532507 | BLUE CROSS BLUE SHIELD (01) | AL |
1649439472 | (05) | AL |
I01024 | (02) | AL |