Individual
JEFFREY D FAGGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1700 SPRING HILL AVE, SUITE 100, MOBILE, AL 36604-1407
(251) 435-1200
(251) 435-6357
Mailing address
1700 SPRING HILL AVE, SUITE 100, MOBILE, AL 36604-1407
(251) 435-1200
(251) 435-6357
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
25661
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25661
MD LICENSE
AL
01
—
511-16667
BCBS
AL
01
—
511-16668
BCBS
AL
01
—
511-16669
BCBS
AL
Enumeration date
03/30/2007
Last updated
09/27/2011
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