Provider Demographics
NPI:1124057963
Name:MGBODILE, FRANCISCA I (MD)
Entity type:Individual
Prefix:
First Name:FRANCISCA
Middle Name:I
Last Name:MGBODILE
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:PO BOX 55310
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5310
Mailing Address - Country:US
Mailing Address - Phone:205-731-9701
Mailing Address - Fax:
Practice Address - Street 1:619 19TH STREET SOUTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233
Practice Address - Country:US
Practice Address - Phone:205-934-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL250522084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051523132OtherBLUE CROSS
AL009956755Medicaid
AL051523134OtherBLUE CROSS
AL009956735Medicaid
AL051523133OtherBLUE CROSS
AL051598416OtherBLUE CROSS
AL1549811OtherUBH-BASIC
AL1549812OtherUBH-PLUS
AL009956745Medicaid
AL330500620OtherMEDICAID REHAB
AL110320Medicaid
MS03489344Medicaid
AL051523132OtherBLUE CROSS