Individual
JOHN M. CANTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2217 DECATUR HWY, SUITE 131, GARDENDALE, AL 35071-2301
(205) 418-1200
(205) 418-1271
Mailing address
2217 DECATUR HWY, SUITE 131, GARDENDALE, AL 35071-2301
(205) 418-1200
(205) 418-1271
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO1085
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215687
CAQH
AL
05
—
1609020866
—
AL
01
—
51106462
BLUE CROSS BLUE SHEILD OF ALABAMA
AL
Enumeration date
11/13/2008
Last updated
12/05/2013
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