Provider Demographics
NPI:1629141643
Name:TRANTHAM, PAMELA (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:TRANTHAM
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 1:801 S FRANKLIN DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:AL
Mailing Address - Zip Code:36081-3838
Mailing Address - Country:US
Mailing Address - Phone:334-566-9800
Mailing Address - Fax:334-566-3700
Practice Address - Street 1:801 S FRANKLIN DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36081-3838
Practice Address - Country:US
Practice Address - Phone:334-566-9800
Practice Address - Fax:334-566-3700
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12695207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51046153OtherBLUECROSS
AL000046153Medicaid
AL000046153Medicaid
AL000046153Medicare ID - Type Unspecified