Provider Demographics
NPI:1356463129
Name:WEST JEFFERSON INTERNAL MEDICINE PC
Entity Type:Organization
Organization Name:WEST JEFFERSON INTERNAL MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REID
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTOPHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-426-0546
Mailing Address - Street 1:1088 9TH AVE SW
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-4530
Mailing Address - Country:US
Mailing Address - Phone:205-426-0546
Mailing Address - Fax:205-426-0326
Practice Address - Street 1:1088 9TH AVE SW
Practice Address - Street 2:SUITE 104
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-4530
Practice Address - Country:US
Practice Address - Phone:205-426-0546
Practice Address - Fax:205-426-0326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALK307Medicare ID - Type Unspecified