Individual
DR. DAVID KERN STALLWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2016 S ALABAMA AVE, MONROEVILLE, AL 36460-3044
(205) 180-3606
Mailing address
200 CORPORATE BLVD, SUITE 201, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
00014114
AL
208600000X
Surgery Physician
Primary
14114
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009910385
MCH SURG MEDICAID PROV
AL
01
—
020054555
MCH SURG RAILROAD PROVIDE
—
01
—
051513418
MCH SURG BCBS PROV. NO.
AL
01
—
051513418
MCH SURG MCARE PROV. NO.
—
05
—
051556564
—
AL
Enumeration date
05/05/2006
Last updated
11/27/2007
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