Provider Demographics
NPI:1386699627
Name:ALFORD, LARRY DOUGLAS JR (MD)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:DOUGLAS
Last Name:ALFORD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DOUG
Other - Middle Name:
Other - Last Name:ALFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 830230
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35283-0230
Mailing Address - Country:US
Mailing Address - Phone:205-250-6000
Mailing Address - Fax:205-250-6848
Practice Address - Street 1:2022 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:SUITE 510
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6808
Practice Address - Country:US
Practice Address - Phone:205-250-6000
Practice Address - Fax:205-250-6848
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20015207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000033883Medicaid
ALG33732Medicare UPIN
000033883Medicare PIN