Individual
J WALDEN RETAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
177 OAK RIDGE LN, TALLADEGA, AL 35160-8303
(205) 266-4928
Mailing address
177 OAK RIDGE LN, TALLADEGA, AL 35160-8303
(205) 266-4928
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3223
AL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
3223
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5241
—
AL
Enumeration date
11/25/2006
Last updated
02/05/2013
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