Provider Demographics
NPI:1730190539
Name:DOODY-LUNDY, REGINA MARIE (MD)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:MARIE
Last Name:DOODY-LUNDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:MARIE
Other - Last Name:DOODY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:190 LIME QUARRY RD
Mailing Address - Street 2:STE 117
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8975
Mailing Address - Country:US
Mailing Address - Phone:256-464-0222
Mailing Address - Fax:256-464-0260
Practice Address - Street 1:190 LIME QUARRY RD
Practice Address - Street 2:STE 117
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8975
Practice Address - Country:US
Practice Address - Phone:256-464-0222
Practice Address - Fax:256-464-0260
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL244732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51514991DOOOtherBCBS
ALG66332Medicare UPIN
AL051514991Medicare ID - Type Unspecified