Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 12074 | AL |
Y | 111NI0900X | Internist | 12074 | AL |
N | 207RA0401X | Internist - Addiction Medicine | 12074 | AL |
N | 207RH0002X | Hospice and Palliative Medicine | 12074 | AL |
NPI | 1801904636 |
---|---|
Provider Name | Dr. William Eugene Alldredge |
First Address | Tuscaloosa, AL 35406-2300 |
Second Address | Tuscaloosa, AL 35406-2300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 30/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
51018436 | BLUE CROSS PROVIDER NUMBER (01) | AL |
528502230 | (05) | AL |
C73001 | (02) | AL |