Provider Demographics
NPI:1932125101
Name:CORTOPASSI, CAESAR JOHN (MD)
Entity Type:Individual
Prefix:
First Name:CAESAR
Middle Name:JOHN
Last Name:CORTOPASSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5295 PRESERVE PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244
Mailing Address - Country:US
Mailing Address - Phone:205-987-4444
Mailing Address - Fax:205-987-4451
Practice Address - Street 1:5295 PRESERVE PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244
Practice Address - Country:US
Practice Address - Phone:205-987-4444
Practice Address - Fax:205-987-4451
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL8529208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51510842OtherBLUE CROSS OF ALABAMA
AL000026582Medicaid
AL009910995Medicaid
AL51026582OtherBLUE CROSS OF ALABAMA
AL51510842OtherBLUE CROSS OF ALABAMA