Provider Demographics
NPI:1851019574
Name:JUDD, JEFF
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:JUDD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 1/2 GREENSBORO AVE
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-1844
Mailing Address - Country:US
Mailing Address - Phone:205-464-8600
Mailing Address - Fax:
Practice Address - Street 1:714 1/2 GREENSBORO AVE
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-1844
Practice Address - Country:US
Practice Address - Phone:205-464-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1035207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services