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Individual

INGRUM W BANKSTON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1780 MCFARLAND BLVD N, TUSCALOOSA, AL 35406-2136
(205) 345-7351
(205) 345-8476
Mailing address
1400 AFFLINK PL STE 101, TUSCALOOSA, AL 35406-2452
(205) 366-9740
(205) 344-9992

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
036178315
IL
208800000X
Urology Physician
Primary
9502
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
114341
AL
01
51067817
BCBS OF ALABAMA
AL
Enumeration date
04/26/2006
Last updated
04/12/2026
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