Provider Demographics
NPI:1801904636
Name:ALLDREDGE, WILLIAM EUGENE (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EUGENE
Last Name:ALLDREDGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 RICE MINE RD N
Mailing Address - Street 2:SUITE B
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2300
Mailing Address - Country:US
Mailing Address - Phone:205-349-4200
Mailing Address - Fax:205-349-4285
Practice Address - Street 1:100 RICE MINE RD N
Practice Address - Street 2:SUITE B
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2300
Practice Address - Country:US
Practice Address - Phone:205-349-4200
Practice Address - Fax:205-349-4285
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12074207RA0401X, 207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL528502230Medicaid
AL51018436OtherBLUE CROSS PROVIDER NUMBER
AL51018436OtherBLUE CROSS PROVIDER NUMBER
AL18436Medicare PIN