Healthcare Provider Details

I. General information

NPI: 1356391783
Provider Name (Legal Business Name): DEE RODRICK DENSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 06/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 TUSCALOOSA AVE SW
BIRMINGHAM AL
35211-1618
US

IV. Provider business mailing address

917 TUSCALOOSA AVE SW
BIRMINGHAM AL
35211-1618
US

V. Phone/Fax

Practice location:
  • Phone: 205-781-7123
  • Fax: 205-781-7168
Mailing address:
  • Phone: 205-781-7123
  • Fax: 205-781-7168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number12082
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: