Provider Demographics
NPI:1407037955
Name:AGEE, RONALD DAVID (DPM)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:DAVID
Last Name:AGEE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 BESSEMER RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35208-4016
Mailing Address - Country:US
Mailing Address - Phone:205-925-5272
Mailing Address - Fax:205-929-0170
Practice Address - Street 1:1529 BESSEMER RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35208-4016
Practice Address - Country:US
Practice Address - Phone:205-925-5272
Practice Address - Fax:205-929-0170
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-26
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL103213EP1101X, 213ER0200X, 213ES0000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL2710019OtherUNITED HEALTH CARE
ALP0010537Medicare PIN
AL0697650001Medicare NSC
ALT68856Medicare UPIN
AL000078681Medicare PIN