Provider Demographics
NPI:1427142637
Name:FAVOR, JUDITH KAREN (MD)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:KAREN
Last Name:FAVOR
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 1:2006 BROOKWOOD MEDICAL CENTER DRIVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209
Mailing Address - Country:US
Mailing Address - Phone:205-397-1286
Mailing Address - Fax:205-397-1340
Practice Address - Street 1:2006 BROOKWOOD MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE 700
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209
Practice Address - Country:US
Practice Address - Phone:205-397-1286
Practice Address - Fax:205-397-1340
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14141207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000084453Medicaid
AL1355191OtherUNITED HEALTHCARE
AL51098588OtherBCBS OF AL
AL51098588OtherBCBS OF AL
AL000084453Medicaid