Provider Demographics
NPI:1831246701
Name:SHADINGER, LIBBY LOVETT (MD)
Entity type:Individual
Prefix:
First Name:LIBBY
Middle Name:LOVETT
Last Name:SHADINGER
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 1:2006 FRANKLIN ST SE STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4537
Mailing Address - Country:US
Mailing Address - Phone:256-539-0457
Mailing Address - Fax:256-539-5827
Practice Address - Street 1:2006 FRANKLIN ST SE
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4551
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:256-539-5827
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL293082085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51599310OtherBCBS
AL110915Medicaid
AL110911Medicaid
AL247946Medicaid
AL51599308OtherBCBS
AL51599312OtherBCBS
AL110912Medicaid
AL110913Medicaid
AL51599307OtherBCBS
AL248801Medicaid
AL211910Medicaid
AL238339AMedicaid
AL248405Medicaid
AL249859Medicaid
AL51599311OtherBCBS
AL51599313OtherBCBS
AL110914Medicaid
AL126700Medicaid
AL136473Medicaid
AL248557Medicaid
AL111067Medicaid
AL247940Medicaid
AL51067369OtherBCBS