Provider Demographics
NPI:1659376911
Name:TORGERSON, CHARLES L II (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:L
Last Name:TORGERSON
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 1:2000A SOUTHBRIDGE PKWY
Mailing Address - Street 2:STE 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7718
Mailing Address - Country:US
Mailing Address - Phone:205-871-4274
Mailing Address - Fax:205-871-4301
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-939-9665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000154822085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009971940Medicaid
AL300070699OtherRAILROAD MEDICARE UAB
AL103563Medicaid
AL515-20577OtherBLUE CROSS
AL515-26084OtherBLUE CROSS
AL103751Medicaid
AL510-31375OtherBLUE CROSS
AL515-04804OtherBCBS (UAB)
MS03602096Medicaid
AL515-90103OtherBLUE CROSS
AL630842160OtherAETNA
AL511-61147OtherBLUE CROSS
AL515-97926OtherBLUE CROSS
AL000031375Medicaid
AL009958785Medicaid
AL009993675Medicaid
AL515-97926OtherBLUE CROSS
AL009971940Medicaid