Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 21499 | AL |
N | 207RC0000X | Internist - Cardiovascular Disease | 21499 | AL |
NPI | 1790705978 |
---|---|
Provider Name | Jose A Tallaj |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 07/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002802636A | (05) | GA |
009967590 | (05) | AL |
051503583 | (05) | AL |
051503583 | BLUE CROSS (01) | AL |
051503584 | BLUE CROSS (01) | AL |
05852049 | MISSISSIPPI MEDICAID (01) | MS |
060064891 | RAILROAD MEDICARE (01) | AL |
1725781 | EMERGENCY LA MEDICAID (01) | LA |