Provider Demographics
NPI:1063704823
Name:LUMSDEN, ROSS ALLEN (MD)
Entity type:Individual
Prefix:
First Name:ROSS
Middle Name:ALLEN
Last Name:LUMSDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 26TH ST S
Mailing Address - Street 2:STE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2412
Mailing Address - Country:US
Mailing Address - Phone:205-332-3155
Mailing Address - Fax:866-644-8086
Practice Address - Street 1:1020 26TH ST S
Practice Address - Street 2:STE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-2412
Practice Address - Country:US
Practice Address - Phone:205-332-3155
Practice Address - Fax:866-644-8086
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL32123208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL109I119220Medicare PIN