Provider Demographics
NPI:1588619795
Name:FRITH, HERBERT C II (MD)
Entity type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:C
Last Name:FRITH
Suffix:II
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 1:3001 DAVENPORT DR SE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON COVE
Mailing Address - State:AL
Mailing Address - Zip Code:35763-8468
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8375 HIGHWAY 72 W
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9573
Practice Address - Country:US
Practice Address - Phone:256-265-5051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.28052207P00000X, 207Q00000X
GA30768207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C83921Medicare UPIN