Provider Demographics
NPI:1750656104
Name:FAULKNER, AUSTIN ROYCE (MD)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:ROYCE
Last Name:FAULKNER
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 1:2006 FRANKLIN ST SE STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4537
Mailing Address - Country:US
Mailing Address - Phone:256-539-0457
Mailing Address - Fax:
Practice Address - Street 1:2006 FRANKLIN ST SE STE 200
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4537
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL361562085R0202X
TN577142085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL215907Medicaid
AL248073Medicaid
AL216382Medicaid
AL216785Medicaid
AL219519Medicaid
AL219564Medicaid
AL220342Medicaid
AL215864Medicaid
AL240242Medicaid
AL245574Medicaid
AL220642Medicaid
AL215865Medicaid
AL1750656104Medicaid
AL216311Medicaid
AL220177Medicaid
AL220704Medicaid
AL245590Medicaid
AL246069Medicaid