Provider Demographics
NPI:1538255922
Name:ALABAMA DIGESTIVE DISEASES,P.C
Entity type:Organization
Organization Name:ALABAMA DIGESTIVE DISEASES,P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:BUCK
Authorized Official - Last Name:LUTTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-481-7384
Mailing Address - Street 1:985 9TH AVE SW
Mailing Address - Street 2:SUITE 307
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-4500
Mailing Address - Country:US
Mailing Address - Phone:205-481-7384
Mailing Address - Fax:205-481-7389
Practice Address - Street 1:985 9TH AVE SW
Practice Address - Street 2:SUITE 307
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-4500
Practice Address - Country:US
Practice Address - Phone:205-481-7384
Practice Address - Fax:205-481-7389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALD267Medicare ID - Type Unspecified