Provider Demographics
NPI:1841384724
Name:SEGREST, JEFF HUDSON (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFF
Middle Name:HUDSON
Last Name:SEGREST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2030 LAY DAM RD
Mailing Address - Street 2:
Mailing Address - City:CLANTON
Mailing Address - State:AL
Mailing Address - Zip Code:35045-8344
Mailing Address - Country:US
Mailing Address - Phone:205-663-5775
Mailing Address - Fax:205-739-2049
Practice Address - Street 1:2030 LAY DAM RD
Practice Address - Street 2:
Practice Address - City:CLANTON
Practice Address - State:AL
Practice Address - Zip Code:35045-8344
Practice Address - Country:US
Practice Address - Phone:205-663-5775
Practice Address - Fax:205-739-2049
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL30865207RC0000X
ALMD.30865207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102I060072Medicare PIN