Provider Demographics
NPI:1689760704
Name:ABNEY, CHARLES EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:EUGENE
Last Name:ABNEY
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 1:3611 WINDY RDG
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-3676
Mailing Address - Country:US
Mailing Address - Phone:205-750-0860
Mailing Address - Fax:205-333-4660
Practice Address - Street 1:809 UNIVERSITY BLVD E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-2029
Practice Address - Country:US
Practice Address - Phone:205-333-4500
Practice Address - Fax:205-333-4522
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21941207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00269346OtherMEDICARE RAILROAD
AL009933262Medicaid
AL051531033OtherBCBS
P00990323OtherMEDICARE RAILROAD
AL127820Medicaid
AL51116107OtherBLUE CROSS/BLUE SHIELD OF ALABAMA
AL127820Medicaid
102I083563Medicare PIN