Healthcare Provider Details

I. General information

NPI: 1396310728
Provider Name (Legal Business Name): UMUT EGE TUFAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2021
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 VETERANS DR
FLORENCE AL
35630-4928
US

IV. Provider business mailing address

1701 VETERANS DR
FLORENCE AL
35630-4928
US

V. Phone/Fax

Practice location:
  • Phone: 424-558-4099
  • Fax:
Mailing address:
  • Phone: 424-558-4099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036175335
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101279334
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.48058
License Number StateAL
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.48058
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: