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Individual

JOHN P WALDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1530 US HIGHWAY 43, WINFIELD, AL 35594-5056
(205) 870-0123
Mailing address
2000A SOUTHBRIDGE PKWY, STE 300, BIRMINGHAM, AL 35209-7718
(205) 871-4274
(205) 871-4301

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19892
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051551925
AL
05
115382
AL
01
511-01854
BLUE CROSS
AL
01
515-10170
BLUE CROSS
AL
01
631247115
AETNA
AL
01
P00050723
RRMC
AL
Enumeration date
07/05/2005
Last updated
09/16/2015
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