Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 5971 | AL |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 5971 | AL |
NPI | 1093792079 |
---|---|
Provider Name | Edward Eaton Palmer JR. |
First Address | Montgomery, AL 36123-5003 |
Second Address | Montgomery, AL 36106-3604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2005 |
Last Update Date | 24/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000055278 | (05) | AL |
000080878 | (05) | AL |
0910185 | UNITED HEALTHCARE (01) | |
200027780 | RR MEDICARE (01) | |
51032887 | BLUE CROSS (01) | |
51055278 | BLUE CROSS (01) | |
550179 | PRIME HEALTH (01) | |
5910114 | AETNA (01) | |
6453 | NCC/TYNET (01) | |
717863 | FIRST HEALTH (01) | |
C75468 | (02) |