Provider Demographics
NPI:1417938085
Name:HERRINGTON, FOREST STEPHEN (MD)
Entity type:Individual
Prefix:
First Name:FOREST
Middle Name:STEPHEN
Last Name:HERRINGTON
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 1:401 LOWELL DR SE STE 24
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3738
Mailing Address - Country:US
Mailing Address - Phone:256-534-7005
Mailing Address - Fax:833-902-4019
Practice Address - Street 1:401 LOWELL DR SE STE 24
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3738
Practice Address - Country:US
Practice Address - Phone:256-534-7005
Practice Address - Fax:833-902-4019
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14154207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0004118765OtherAETNA
631027360OtherTAX ID
AL000086778Medicaid
AL51086778OtherBLUE CROSS BLUE SHIELD
080019114OtherRAILROAD MEDICARE
0004118765OtherAETNA
080019114OtherRAILROAD MEDICARE