Individual
VIRGIL THOMAS BACCUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1890 AL HWY 157, SUITE 220, CULLMAN, AL 35058
(256) 739-2626
(256) 739-6588
Mailing address
1890 AL HWY 157, SUITE 220, CULLMAN, AL 35058
(256) 739-2626
(256) 739-6588
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
5397
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4044923
AETNA
AL
Enumeration date
07/20/2006
Last updated
07/08/2007
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