Healthcare Provider Details

I. General information

NPI: 1467090506
Provider Name (Legal Business Name): NELSON D AGEE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2019
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 MEDICAL WEST WAY
BESSEMER AL
35022-7082
US

IV. Provider business mailing address

2837 CROSS BRIDGE DR
VESTAVIA HILLS AL
35216-7103
US

V. Phone/Fax

Practice location:
  • Phone: 205-820-8416
  • Fax:
Mailing address:
  • Phone: 205-922-9826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number1827
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: