MEDICARE: TUSCALOOSA SURGICAL ASSOCIATES, P.C.

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	208600000X	Surgery Physician	22573	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

General Provider Information

NPI Number	:	1881614329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TUSCALOOSA SURGICAL ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	1837 COMMONS NORTH DR
Second Line	:
City	:	TUSCALOOSA
State	:	AL
Zip	:	35406-3700
Country	:	US
Telephone Number	:	205-366-0696
Fax Number	:	205-366-1451

Provider Business Practice Location Address
First Line	:	1837 COMMONS NORTH DR
Second Line	:
City	:	TUSCALOOSA
State	:	AL
Zip	:	35406-3700
Country	:	US
Telephone Number	:	205-366-0696
Fax Number	:	205-366-1451

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WILLIAM LANGLEY PRIDGEN
Credential	:	M.D.
Telephone Number	:	205-366-0696

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	01/18/2011

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