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Individual

DR. SALLY MCNEILL EBAUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1700 4TH AVE N, BESSEMER, AL 35020-4837
(205) 481-8650
Mailing address
PO BOX 11407, BIRMINGHAM, AL 35246-0777
(205) 481-7670
(205) 481-7573

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00020048
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009941423
AL
01
0111312
MEDICARE COMPLETE
AL
01
051005158
BLUE CROSS
AL
01
18386
SENIORS FIRST
AL
01
G36327
VIVA HEALTH
AL
Enumeration date
09/01/2006
Last updated
05/04/2021
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