=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558858613
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YVONNE CHODABA CONWAY MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/15/2018
-----------------------------------------------------
Last Update Date | 07/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5850 VALLEY RD STE 110
-----------------------------------------------------
City | TRUSSVILLE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35235-8683
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-939-0447
-----------------------------------------------------
Fax | 205-838-3043
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 833 SAINT VINCENTS DR STE 403
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35205-1614
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-939-0447
-----------------------------------------------------
Fax | 205-939-0418
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207XX0004X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
-----------------------------------------------------
License Number | MD.38846
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------