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Individual

CLIFTON A LATTING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1517 19TH STREET ENSLEY, BIRMINGHAM, AL 35218-2049
(205) 785-0055
(205) 780-5223
Mailing address
1517 19TH STREET ENSLEY, BIRMINGHAM, AL 35218-2049
(205) 785-0055
(205) 780-5223

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
8248
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000000766
AL
01
051000766
BCBS #
AL
01
110030732
RAILROAD MEDICARE
AL
Enumeration date
08/04/2006
Last updated
05/25/2010
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