Provider Demographics
NPI:1124035795
Name:CHANCE, ALFRED BYRON JR (MD)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:BYRON
Last Name:CHANCE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3280 DAUPHIN ST
Mailing Address - Street 2:BUILDING B, SUITE 118
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-4060
Mailing Address - Country:US
Mailing Address - Phone:251-545-4579
Mailing Address - Fax:251-287-1466
Practice Address - Street 1:5 MOBILE INFIRMARY CIR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3513
Practice Address - Country:US
Practice Address - Phone:251-545-4579
Practice Address - Fax:251-287-1466
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00014135207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC73150Medicare UPIN
ALC73150Medicare UPIN
AL000029294Medicaid
AL29294OtherBC
ALG583Medicare PIN