Provider Demographics
NPI:1174694160
Name:FROST, LOUIS (MD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:FROST
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 1:2801 HIGHWAY 280 SOUTH
Mailing Address - Street 2:ATTN: UNDERWRITING DEPARTMENT
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35223
Mailing Address - Country:US
Mailing Address - Phone:205-268-6189
Mailing Address - Fax:
Practice Address - Street 1:2801 HIGHWAY 280 SOUTH
Practice Address - Street 2:ATTN: UNDERWRITING DEPARTMENT
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35223
Practice Address - Country:US
Practice Address - Phone:205-268-6189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2022-09-16
Deactivation Date:2019-03-27
Deactivation Code:
Reactivation Date:2022-09-16
Provider Licenses
StateLicense IDTaxonomies
TXL6899207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine