Healthcare Provider Details

I. General information

NPI: 1801904636
Provider Name (Legal Business Name): WILLIAM EUGENE ALLDREDGE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 01/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 RICE MINE RD N SUITE B
TUSCALOOSA AL
35406-2300
US

IV. Provider business mailing address

100 RICE MINE RD N SUITE B
TUSCALOOSA AL
35406-2300
US

V. Phone/Fax

Practice location:
  • Phone: 205-349-4200
  • Fax: 205-349-4285
Mailing address:
  • Phone: 205-349-4200
  • Fax: 205-349-4285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number12074
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number12074
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number12074
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: