Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 31629 | AL |
NPI | 1184755621 |
---|---|
Provider Name | Norman E. Waldrop III |
First Address | Birmingham, AL 35205-1636 |
Second Address | Birmingham, AL 35205-1636 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 21/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
511-25468 | BLUE CROSS (01) | AL |