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Individual

THEODORE STEVENS FEELY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
817 PRINCETON AVENUE SW, PROFESSIONAL OFFICE BLDG II, SUITE 206, BIRMINGHAM, AL 35211
(205) 226-5900
(205) 226-5937
Mailing address
73 WEST LAKESHORE DRIVE, SUITE 200, BIRMINGHAM, AL 35209
(205) 226-5900
(205) 226-5937

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
060832
GA
207R00000X
Internal Medicine Physician
200500182
NC
207RN0300X
Nephrology Physician
060832
GA
207RN0300X
Nephrology Physician
Primary
34508
AL
208M00000X
Hospitalist Physician
MD.34508
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1241808
AMERIGROUP
GA
05
196561329A
GA
01
52260873 001
BCBS - GA
GA
01
N460702
WELLCARE
GA
01
P00649787
MEDICARE - RAILROAD
GA
Enumeration date
01/17/2007
Last updated
11/20/2018
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