Healthcare Provider Details

I. General information

NPI: 1851439582
Provider Name (Legal Business Name): METRO WEST MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 07/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 PRINCETON AVE SW POB I SUITE 406
BIRMINGHAM AL
35211-1310
US

IV. Provider business mailing address

801 PRINCETON AVE SW POB I SUITE 406
BIRMINGHAM AL
35211-1310
US

V. Phone/Fax

Practice location:
  • Phone: 205-788-6688
  • Fax: 205-788-0305
Mailing address:
  • Phone: 205-788-6688
  • Fax: 205-788-0305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIE WILLIAMS JR.
Title or Position: PRESIDENT
Credential: MD
Phone: 205-397-9214