Provider Demographics
NPI:1457845067
Name:DENSMORE, CAROLINE HICKS (MD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:HICKS
Last Name:DENSMORE
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 1:1601 4TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1723
Mailing Address - Country:US
Mailing Address - Phone:205-638-9585
Mailing Address - Fax:205-975-6503
Practice Address - Street 1:1601 4TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1723
Practice Address - Country:US
Practice Address - Phone:205-638-9585
Practice Address - Fax:205-975-6503
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.44197208000000X
IAR-113222080P0202X, 2080P0206X, 2080A0000X, 2080N0001X, 2080P0206X, 2080P0207X
IAMD-48569208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology