Basic Information
Provider Information
NPI: 1871596205
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRAMMELL
FirstName: DALE
MiddleName: E.
NamePrefix: DR.
NameSuffix: JR.
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 840 MONTCLAIR RD
Address2: STE 500
City: BIRMINGHAM
State: AL
PostalCode: 352131946
CountryCode: US
TelephoneNumber: 2055955504
FaxNumber: 2055953427
Practice Location
Address1: 840 MONTCLAIR RD
Address2: STE 500
City: BIRMINGHAM
State: AL
PostalCode: 352131946
CountryCode: US
TelephoneNumber: 2055955504
FaxNumber: 2055953427
Other Information
ProviderEnumerationDate: 05/31/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X21450ALY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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