Provider Demographics
NPI:1528359007
Name:PRIDGEN, ELIZABETH HESS (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HESS
Last Name:PRIDGEN
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 1:2015 KENTUCKY AVE
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1905
Mailing Address - Country:US
Mailing Address - Phone:205-438-6009
Mailing Address - Fax:833-799-3664
Practice Address - Street 1:2015 KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1905
Practice Address - Country:US
Practice Address - Phone:205-438-6009
Practice Address - Fax:833-799-3664
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL32156208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice