Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MD.14392 | AL |
NPI | 1003898164 |
---|---|
Provider Name | Janyce M Sanford |
First Address | Birmingham, AL 35246-0624 |
Second Address | Birmingham, AL 35249-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 17/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000076092 | (05) | AL |
009912477 | (05) | AL |
1003898164 | TRICARE SOUTH (01) | AL |
510-76092 | BCBS (01) | AL |
515-44871 | BCBS (01) | AL |
E43127 | (02) | AL |