Provider Demographics
NPI:1922218270
Name:FRANK H. RUDESEAL, M.D., P.C.
Entity Type:Organization
Organization Name:FRANK H. RUDESEAL, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:H
Authorized Official - Last Name:RUDESEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-949-1980
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:JEMISON
Mailing Address - State:AL
Mailing Address - Zip Code:35085-0936
Mailing Address - Country:US
Mailing Address - Phone:205-949-1990
Mailing Address - Fax:
Practice Address - Street 1:2057 VALLEYDALE RD STE 220
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-2706
Practice Address - Country:US
Practice Address - Phone:205-949-1980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00011696207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000025063Medicaid
AL25063OtherBCBS
ALC74005Medicare UPIN