Provider Demographics
NPI:1922154061
Name:SANDERS, PATRICIA ANN (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 INVERNESS PLZ
Mailing Address - Street 2:SUITE 115
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4800
Mailing Address - Country:US
Mailing Address - Phone:205-786-1160
Mailing Address - Fax:
Practice Address - Street 1:1006 LAY DAM RD
Practice Address - Street 2:
Practice Address - City:CLANTON
Practice Address - State:AL
Practice Address - Zip Code:35045-2306
Practice Address - Country:US
Practice Address - Phone:205-280-3360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4566207VG0400X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009938075Medicaid
AL051115509OtherBLUE CROSS BLUE SHEILD
AL051517976OtherBLUE CROSS BLUE SHEILD
AL051123350OtherAL BCBS BROOKWOOD HOSPITAL
AL127629Medicaid
AL051009654OtherBLUE CROSS BLUE SHIELD
AL051009654OtherBLUE CROSS BLUE SHIELD