Provider Demographics
NPI:1154326353
Name:DEATKINE, ANNE B (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:B
Last Name:DEATKINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000A SOUTHBRIDGE PKWY
Mailing Address - Street 2:STE 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7718
Mailing Address - Country:US
Mailing Address - Phone:205-871-4274
Mailing Address - Fax:205-871-4301
Practice Address - Street 1:1000 1ST ST N
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8703
Practice Address - Country:US
Practice Address - Phone:205-620-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL170722085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009912243Medicaid
AL051535034OtherBLUE CROSS
AL051553914Medicaid
AL1611283OtherUHC
AL4323624OtherAETNA
AL051524498OtherBLUE CROSS
AL051516732OtherBLUE CROSS
AL051516731OtherBLUE CROSS
AL009995645Medicaid
AL051553914Medicaid
AL051516732OtherBLUE CROSS
AL009912243Medicaid
AL051516731OtherBLUE CROSS