Healthcare Provider Details

I. General information

NPI: 1154426872
Provider Name (Legal Business Name): GREG E EUDY MD PC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2022 BROOKWOOD MEDICAL CENTER DRIVE SUITE 211
BIRMINGHAM AL
35209
US

IV. Provider business mailing address

2022 BROOKWOOD MEDICAL CENTER DRIVE SUITE 211
BIRMINGHAM AL
35209
US

V. Phone/Fax

Practice location:
  • Phone: 205-877-2955
  • Fax: 205-877-2969
Mailing address:
  • Phone: 205-877-2955
  • Fax: 205-877-2969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number25913
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: