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Individual

DR. JORGE ALBERTO VIDAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
619 19TH ST S, BIRMINGHAM, AL 35249-1900
(205) 934-8978
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
D64849
MD
2085N0700X
Neuroradiology Physician
D64849
MD
2085N0904X
Nuclear Radiology Physician
D64849
MD
2085P0229X
Pediatric Radiology Physician
D64849
MD
2085R0001X
Radiation Oncology Physician
D64849
MD
2085R0202X
Diagnostic Radiology Physician
2007029610
MO
2085R0202X
Diagnostic Radiology Physician
Primary
35926
AL
2085R0202X
Diagnostic Radiology Physician
D64849
MD
2085R0203X
Therapeutic Radiology Physician
D64849
MD
2085R0204X
Vascular & Interventional Radiology Physician
D64849
MD
2085U0001X
Diagnostic Ultrasound Physician
D64849
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1487664454
MO
01
39128011
BCBS KANSAS CITY MO
MO
01
P00467069
RR MEDICARE FOR GROUP DG5646
MO
Enumeration date
08/09/2006
Last updated
05/04/2017
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