Individual
DR. JULENE RANICEA PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1308 TUSCALOOSA AVE SW, BIRMINGHAM, AL 35211-1948
(205) 715-6121
(205) 715-6183
Mailing address
1308 TUSCALOOSA AVE SW, BIRMINGHAM, AL 35211-1948
(205) 715-6121
(205) 715-6183
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00017145
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051032285
BLUE SHIELD OF AL.
AL
01
—
1396770913
GROUP PAYEE NPI
AL
05
—
303790344
—
AL
01
—
G592
MEDICARE GROUP NUMBER
AL
Enumeration date
02/01/2006
Last updated
06/15/2010
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