Individual
SAMUEL T WINDHAM III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-6600
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20175
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010033CH42166
SECTION 1011
AL
01
—
09038349
MISSISSPPI MEDICAID
MS
01
—
1518832
EMERGENCY LA MEDICAID
LA
Enumeration date
07/25/2006
Last updated
07/08/2007
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