Healthcare Provider Details

I. General information

NPI: 1487720355
Provider Name (Legal Business Name): ALABAMA ORTHOPAEDIC CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 04/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 HOSPITAL AVE
JACKSON AL
36545
US

IV. Provider business mailing address

3610 SPRINGHILL MEMORIAL DR N
MOBILE AL
36608-1162
US

V. Phone/Fax

Practice location:
  • Phone: 251-246-5761
  • Fax:
Mailing address:
  • Phone: 251-410-3600
  • Fax: 251-410-3819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number056904
License Number StateAL

VIII. Authorized Official

Name: DR. RUSSELL HUDGENS
Title or Position: PRESIDENT
Credential:
Phone: 251-410-3600