Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 25156 | MS |
N | 207X00000X | Orthopaedic Surgeon | 55669 | TN |
N | 207X00000X | Orthopaedic Surgeon | MD.33079 | AL |
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD.33079 | AL |
NPI | 1174889885 |
---|---|
Provider Name | Joseph Matthew Ingram |
First Address | Birmingham, AL 35235-3134 |
Second Address | Birmingham, AL 35235 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2012 |
Last Update Date | 17/05/2018 |