Provider Demographics
NPI:1114905429
Name:ALFORD, CHAD M (MD)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:M
Last Name:ALFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 AIRPORT BLVD
Mailing Address - Street 2:SUITE A107
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-6705
Mailing Address - Country:US
Mailing Address - Phone:251-433-4700
Mailing Address - Fax:251-435-8549
Practice Address - Street 1:6701 AIRPORT BLVD
Practice Address - Street 2:SUITE A107
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-6705
Practice Address - Country:US
Practice Address - Phone:251-433-4702
Practice Address - Fax:251-435-8615
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22563174400000X, 207RI0011X
MS16408174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1063477644OtherGROUP NPI
AL1114905429OtherINDIVIDUAL NPI
ALG364OtherGROUP MEDICARE NUMBER
AL000008468Medicaid
MS00121124Medicaid
AL1114905429OtherINDIVIDUAL NPI
AL000008468Medicaid
ALG364OtherGROUP MEDICARE NUMBER
MS060000327Medicare PIN