Unknown Individual – Surgery Physician, NPI 1629138151

Unknown Individual is a healthcare provider. based in Florence, Alabama. specializing in Surgery Physician. They hold a License No. 6087 (AL). The NPI Number for Unknown Individual is 1629138151

Main info

Organization
Inactive
60 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1629138151
Phone
(256) 768-8600
Address
212 TREE LINE CT
Deactivation Date
19 April 2021

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
2567688600
Graduation Year
1966 (60 years ago)
PAC ID
4385738764
Professional Enrollment ID
I20100211000214
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 212, Tree Line Court, Cedar Park, Florence, Lauderdale County, Alabama, 35630, United States

    FLORENCE, AL 356306670

    Phone: (256) 768-8600

    Type: Mailing

  • ECM East Diagnostic and Business Center, 2111, Cloyd Boulevard, Florence, Lauderdale County, Alabama, 35630, United States

    FLORENCE, AL 356301503

    Phone: (256) 768-8600

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35630)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1629138151 on file in the registry.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Surgery Physician. Clinical services aligned with this taxonomy classification.
Where in Alabama is Unknown Individual registered?
Use Florence, Alabama as the headline location for Unknown Individual here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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