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General NPI Number Information
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NPI Number | 1467090506
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Entity Type | Individual
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Provider Name | NELSON D AGEE
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Gender | Male
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Dates
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Enumeration Date | 12/19/2019
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 3686 GRANDVIEW PKWY STE 430
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City | BIRMINGHAM
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State | AL
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Zip | 35243-3404
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Country | US
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Telephone | 205-605-8180
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Fax |
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Provider Business Mailing Address
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Address Line | 2837 CROSS BRIDGE DR
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City | VESTAVIA HILLS
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State | AL
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Zip | 35216-7103
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Country | US
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Telephone | 205-922-9826
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | 1847
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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