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1821052424

NPI Code Detail

MEDICARE: DAVID DEAN THORNTON MD

MEDICARE: DAVID DEAN THORNTON 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	20215	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	51000905	OTHER	AL	BLUE CROSS BLUE SHIELD
4	51526364	OTHER	AL	BLUE CROSS/BLUE SHIELD
5	51526323	OTHER	AL	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1821052424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID DEAN THORNTON MD

Provider Business Mailing Address
First Line	:	4517 SOUTHLAKE PKWY
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-3280
Country	:	US
Telephone Number	:	205-985-4111
Fax Number	:	205-985-4326

Provider Business Practice Location Address
First Line	:	4517 SOUTHLAKE PKWY
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-3280
Country	:	US
Telephone Number	:	205-985-4111
Fax Number	:	205-985-4326

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

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	09/06/2023

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Directions to “ DAVID DEAN THORNTON MD” Practice Location

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