Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 075730 | GA |
N | 204F00000X | Transplant Surgeon | 37011 | AL |
Y | 208200000X | Surgeon | 37011 | AL |
Y | 208600000X | Surgeon | 37011 | AL |
NPI | 1073756201 |
---|---|
Provider Name | Dr. Douglas James Anderson |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35233-2110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2009 |
Last Update Date | 07/01/2019 |