Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 00005157 | AL |
NPI | 1013954718 |
---|---|
Provider Name | Dr. William Douglas Sudduth |
First Address | Hoover, AL 35244-3280 |
Second Address | Hoover, AL 35244-3280 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 27/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051007158 | BLUE CROSS BLUE SHIELD (01) | AL |
101850 | (05) | AL |
C75523 | (02) | AL |