Provider Demographics
NPI:1215973524
Name:AMMON, JOHN ERIC (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ERIC
Last Name:AMMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:833 SAINT VINCENTS DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1606
Mailing Address - Country:US
Mailing Address - Phone:205-933-4640
Mailing Address - Fax:
Practice Address - Street 1:833 SAINT VINCENTS DR
Practice Address - Street 2:SUITE 300
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1606
Practice Address - Country:US
Practice Address - Phone:205-939-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18194207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALF79973OtherVIVA
AL1215973524OtherHEALTH SPRING
AL156450Medicaid
AL51144053OtherBLUE CROSS BLUE SHIELD OF ALABAMA
AL51144053OtherBLUE CROSS BLUE SHIELD OF ALABAMA
ALF79973OtherVIVA