Provider Demographics
NPI:1992765945
Name:COOL, TIMOTHY ALDEN (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:ALDEN
Last Name:COOL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:48 MEDICAL PARK EAST DR
Mailing Address - Street 2:SUITE 255
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235
Mailing Address - Country:US
Mailing Address - Phone:205-838-3090
Mailing Address - Fax:205-838-6783
Practice Address - Street 1:48 MEDICAL PARK EAST DR
Practice Address - Street 2:SUITE 255
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235
Practice Address - Country:US
Practice Address - Phone:205-838-3090
Practice Address - Fax:205-838-6783
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2010-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11437207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000081417Medicaid
AL000081417Medicaid
510I200111Medicare PIN
000081417Medicare PIN