Provider Demographics
NPI:1629139332
Name:RED MOUNTAIN INTERNISTS PC
Entity Type:Organization
Organization Name:RED MOUNTAIN INTERNISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CECIL
Authorized Official - Middle Name:CALVERT
Authorized Official - Last Name:DODSON
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:205-599-3860
Mailing Address - Street 1:860 MONTCLAIR RD
Mailing Address - Street 2:SUITE 860
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1923
Mailing Address - Country:US
Mailing Address - Phone:205-599-3860
Mailing Address - Fax:205-599-3869
Practice Address - Street 1:860 MONTCLAIR RD
Practice Address - Street 2:SUITE 860
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1923
Practice Address - Country:US
Practice Address - Phone:205-599-3860
Practice Address - Fax:205-599-3869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0529603150Medicaid
AL0D369Medicare PIN