Provider Demographics
NPI:1326013558
Name:RIDGEWAY, ALBERT LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:LYNN
Last Name:RIDGEWAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:A
Other - Middle Name:LYNN
Other - Last Name:RIDGEWAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2587
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35662-2587
Mailing Address - Country:US
Mailing Address - Phone:256-383-4473
Mailing Address - Fax:256-381-5232
Practice Address - Street 1:342 COX BLVD
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-4000
Practice Address - Country:US
Practice Address - Phone:256-383-4473
Practice Address - Fax:256-381-5232
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17451174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALF68311Medicare UPIN