Provider Demographics
NPI:1275644627
Name:DAVID JUDGE, MD, PC
Entity Type:Organization
Organization Name:DAVID JUDGE, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:JUDGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-943-4600
Mailing Address - Street 1:200 WILDWOOD PKWY STE 100B
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7300
Mailing Address - Country:US
Mailing Address - Phone:205-943-4600
Mailing Address - Fax:205-943-4688
Practice Address - Street 1:2015 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5551
Practice Address - Country:US
Practice Address - Phone:256-547-2025
Practice Address - Fax:256-547-2019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALK694Medicare ID - Type Unspecified
ALDE9795OtherRAILROAD MEDICARE
AL1275644627Medicaid
AL529926810Medicaid
AL1275644627Medicare PIN