Healthcare Provider Details

I. General information

NPI: 1073553897
Provider Name (Legal Business Name): JAMES M CORDER III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 01/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 RICE MINE RD N SUITE 200
TUSCALOOSA AL
35406-3281
US

IV. Provider business mailing address

701 UNIVERSITY BLVD E SUITE 604
TUSCALOOSA AL
35401-2086
US

V. Phone/Fax

Practice location:
  • Phone: 205-333-4949
  • Fax: 205-333-4660
Mailing address:
  • Phone: 205-759-6925
  • Fax: 205-759-6926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number25573
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: