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1538164785

NPI Code Detail

MEDICARE: BIBB ALLEN JR. MD

MEDICARE: BIBB ALLEN JR. 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	2085R0202X	Diagnostic Radiology Physician	00011916	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	051540923	OTHER	AL	BLUE CROSS
4	515-42681	OTHER	AL	BLUE CROSS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	511-60811	OTHER	AL	BLUE CROSS
7	515-40923	OTHER	AL	BLUE CROSS
8	4123296	OTHER	AL	AETNA
9	051082157	OTHER	AL	BLUE CROSS
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	051505048	OTHER	AL	BLUE CROSS
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538164785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BIBB ALLEN JR. MD

Provider Business Mailing Address
First Line	:	2000A SOUTHBRIDGE PKWY
Second Line	:	STE 300
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-7718
Country	:	US
Telephone Number	:	205-871-4274
Fax Number	:	205-871-4301

Provider Business Practice Location Address
First Line	:	800 MONTCLAIR RD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35213-1908
Country	:	US
Telephone Number	:	205-592-1000
Fax Number	:

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	12/30/2015

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Directions to “ BIBB ALLEN JR. MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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