DataLabs

datalabs.health made in the usa

Contact us Sign in | Documentation |

divider

Medicare/Medicaid Verification Programs divider

divider

Medicare Verification Program divider

divider

1750386942

NPI Code Detail

MEDICARE: WILTON RUSSELL HOLMAN III MD

MEDICARE: WILTON RUSSELL HOLMAN III 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	20544	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	515-39411	OTHER	AL	BLUE CROSS
3	300113603	OTHER	AL	RRMC
4	515-94523	OTHER	AL	BLUE CROSS
5	511-56374	OTHER	AL	BLUE CROSS
6	7575354	OTHER	AL	AETNA
7	511-09727	OTHER	AL	BLUE CROSS
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	510-55398	OTHER	AL	BLUE CROSS
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750386942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILTON RUSSELL HOLMAN III 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	:	701 PRINCETON AVE SW
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35211-1303
Country	:	US
Telephone Number	:	205-783-3000
Fax Number	:

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

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

Similar Medicare Providers

1932692456 — AKSHUN KALIA MD
Practice Location Address:

701 PRINCETON AVE SW
BIRMINGHAM, AL
35211-1303

Practice Phone: 205-783-3192
Practice Fax:

1043215239 — RICARDO BRACER MD
Practice Location Address:

701 PRINCETON AVE SW
BIRMINGHAM, AL
35211-1303

Practice Phone: 205-868-6209
Practice Fax:

1033114228 — BRYAN E BILLIONS MD
Practice Location Address:

701 PRINCETON AVE SW
BIRMINGHAM, AL
35211-1303

Practice Phone: 205-783-3000
Practice Fax:

1659376846 — ALTON W BAKER MD
Practice Location Address:

701 PRINCETON AVE SW
BIRMINGHAM, AL
35211-1303

Practice Phone: 205-783-3000
Practice Fax:

1013909670 — BAPTIST HOME CARE SERVICES
Practice Location Address:

701 PRINCETON AVE SW
BIRMINGHAM, AL
35211-1303

Practice Phone: 205-783-7922
Practice Fax: 205-783-7964

1669452587 — MRS. MARCIA DELOIS BOSWELL CRNA
Practice Location Address:

701 PRINCETON AVE SW
BIRMINGHAM, AL
35211-1303

Practice Phone: 205-783-3144
Practice Fax: 205-783-3195

Directions to “ WILTON RUSSELL HOLMAN III 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.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.