Provider Demographics
NPI:1871594176
Name:FELGNER, CHARLES F (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:F
Last Name:FELGNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 HWY 280 S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5028
Mailing Address - Country:US
Mailing Address - Phone:205-259-3991
Mailing Address - Fax:205-683-2468
Practice Address - Street 1:1 W LAKESHORE DR STE 100
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-7271
Practice Address - Country:US
Practice Address - Phone:205-930-2950
Practice Address - Fax:205-930-2957
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051507939Medicaid
AL102977Medicaid
ALP00728703OtherRAILROAD MEDICARE
AL51594398OtherBCBS
AL51507939OtherBCBS
AL051507939Medicare ID - Type Unspecified
ALP00728703OtherRAILROAD MEDICARE
AL51507939OtherBCBS
AL051507939Medicaid