Provider Demographics
NPI:1063702959
Name:ELDREDGE, JENNIFER PHILLIPS (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:PHILLIPS
Last Name:ELDREDGE
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 1:1600 7TH AVE S
Mailing Address - Street 2:420 LOWDER BLDG
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1711
Mailing Address - Country:US
Mailing Address - Phone:205-638-9235
Mailing Address - Fax:205-638-9936
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:420 LOWDER BLDG
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-638-9235
Practice Address - Fax:205-638-9936
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLTRN21039390200000X
ALMD.31912390200000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program