| Doctor Name: | MR. TONNY LYNN PRIDGEN |
| NPI Number: | 1659534709 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PARAMEDIC |
| License Number: | 9142360 |
| Business Practice Address: | Bld 301 Andrews Ave Lyster Army Health Clinic Ft Rucker, AL - 36362 |
| Business Phone Number: | 3342557850 |
| Business Fax Number: | |
| Mailing Address: | Bld 301 Andrews Ave, Lyster Army Health Clinic FT RUCKER |
| State: | AL |
| Postal Code: | 36362 |
| Phone Number: | 3342557850 |
| Fax Number: | |
| NPI Enumeration Date: | 07/09/2008 |
| NPI Last Update Date: | 03/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 146L00000X |
| License Number: | 9142360 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AL |
| Taxonomy Type: | Emergency Medical Service Providers |
| Taxonomy Classification: | Emergency Medical Technician, Paramedic |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An EMT, Paramedic is an individual trained and certified to perform advanced life support (ALS) in medical emergencies based on individual state boards. |