Provider Demographics
NPI:1548284193
Name:DAGGETT, ALISON LEAH (MD)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:LEAH
Last Name:DAGGETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 143
Mailing Address - Street 2:
Mailing Address - City:FULTONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35068-0143
Mailing Address - Country:US
Mailing Address - Phone:205-874-8300
Mailing Address - Fax:205-874-8333
Practice Address - Street 1:2010 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6804
Practice Address - Country:US
Practice Address - Phone:205-877-1000
Practice Address - Fax:205-874-8333
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00023651207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL63-1276736OtherTAX ID
AL051503029OtherBLUE CROSS OF ALABAMA
AL009962580Medicaid
ALG35459Medicare UPIN
AL051503029Medicare ID - Type Unspecified