Healthcare Provider Details

I. General information

NPI: 1578397378
Provider Name (Legal Business Name): HUELLAS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1529 BESSEMER RD
BIRMINGHAM AL
35208-4016
US

IV. Provider business mailing address

1529 BESSEMER RD
BIRMINGHAM AL
35208-4016
US

V. Phone/Fax

Practice location:
  • Phone: 205-925-5272
  • Fax: 205-929-0170
Mailing address:
  • Phone: 205-925-5272
  • Fax: 205-929-0170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. RONALD DAVID AGEE
Title or Position: PODIATRIST/CEO
Credential: DPM
Phone: 205-925-5272