MEDICARE: ELIZABETH HESS PRIDGEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	32156	AL

General Provider Information

NPI Number	:	1528359007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH HESS PRIDGEN MD

Provider Business Mailing Address
First Line	:	2015 KENTUCKY AVE
Second Line	:
City	:	VESTAVIA HILLS
State	:	AL
Zip	:	35216-1905
Country	:	US
Telephone Number	:	205-438-6009
Fax Number	:	833-799-3664

Provider Business Practice Location Address
First Line	:	2015 KENTUCKY AVE
Second Line	:
City	:	VESTAVIA HILLS
State	:	AL
Zip	:	35216-1905
Country	:	US
Telephone Number	:	205-438-6009
Fax Number	:	833-799-3664

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2011
Last Update Date	:	12/06/2023

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