Provider Demographics
NPI:1811971831
Name:JOE, GEORGE L (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:L
Last Name:JOE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2016 STONEGATE TRAIL
Mailing Address - Street 2:SUITE 112
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2260
Mailing Address - Country:US
Mailing Address - Phone:205-545-9530
Mailing Address - Fax:205-545-9529
Practice Address - Street 1:50 MEDICAL PARK DR E
Practice Address - Street 2:ST. VINCENT'S EAST
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3401
Practice Address - Country:US
Practice Address - Phone:205-545-9530
Practice Address - Fax:205-545-9529
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00008153207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0009977300Medicaid
AL351890800OtherDEPT OF LABOR
ALC144OtherBCBS
AL631257475OtherTAX ID
ALC141OtherBCBS
AL529905830Medicaid
AL604336100OtherDEPT OF LABOR
ALCH5239OtherRR MEDICARE
AL529910000Medicaid
ALCK8418OtherRR MEDICARE
ALC144OtherBCBS
ALC70157Medicare UPIN
ALJ270Medicare PIN
ALC141OtherBCBS