Provider Demographics
NPI:1568457190
Name:PAPAGNI, MARIO B (MD)
Entity Type:Individual
Prefix:
First Name:MARIO
Middle Name:B
Last Name:PAPAGNI
Suffix:
Gender:M
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:PO BOX 11407 LOCKBOX 1066
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-1066
Mailing Address - Country:US
Mailing Address - Phone:205-437-6098
Mailing Address - Fax:205-437-5998
Practice Address - Street 1:150 GILBREATH DR
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:AL
Practice Address - Zip Code:35121-2827
Practice Address - Country:US
Practice Address - Phone:205-274-3004
Practice Address - Fax:205-274-3002
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00006685207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051554487Medicaid
AL009914083Medicaid
AL051522586Medicaid
AL051009629OtherBCBS
AL051520364OtherBCBS
AL051522586OtherBCBS PROVIDER NUMBER
AL5836556OtherAETNA
AL051522586OtherBCBS PROVIDER NUMBER
AL051522586Medicaid
AL5836556OtherAETNA
AL051520364OtherBCBS
AL051009629OtherBCBS
ALP00121477Medicare PIN