J Walden Retan MD PC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

3223 Issued in AL

Legal business name

J WALDEN RETAN MD PC

Practice address

3105 Warrington Road
Mountain Brook, AL 35223-2721

Phone

(205) 967-2900

Fax

(205) 967-0069

NPI assigned

Aug 18, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

J Walden Retan, MD

Title

President

Phone

(205) 967-2900

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• J Walden Retan MD PA Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952415994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 WARRINGTON ROAD",
            "city": "MOUNTAIN BROOK",
            "state": "AL",
            "postal_code": "352232721",
            "telephone_number": "205-967-2900",
            "fax_number": "205-967-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 WARRINGTON ROAD",
            "city": "MOUNTAIN BROOK",
            "state": "AL",
            "postal_code": "352232721",
            "telephone_number": "205-967-2900",
            "fax_number": "205-967-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J WALDEN RETAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RETAN",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "WALDEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-967-2900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AL",
            "license": "3223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51005240",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "J Walden Retan MD PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Geriatric Medicine (Internal Medicine) Physician in Mountain Brook, AL
• Providers in Mountain Brook, AL by specialty
• Geriatric Medicine (Internal Medicine) Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.