Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 28496 | AL |
N | 207RP1001X | Pulmonary Disease | 28496 | AL |
N | 208000000X | Pediatrician | 28496 | AL |
NPI | 1154543452 |
---|---|
Provider Name | John Talyor Anderson |
First Address | Birmingham, AL 35255-5310 |
Second Address | Homewood, AL 35209-6802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 11/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00752754 | (05) | MS |
051116644 | BCBS (01) | AL |
051116645 | BCBS (01) | AL |
051116646 | BCBS (01) | AL |
128675 | (05) | AL |
128676 | (05) | AL |
128677 | (05) | AL |