Healthcare Provider Details

I. General information

NPI: 1811925241
Provider Name (Legal Business Name): WILLIAM D SUMMERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 03/06/2020
Certification Date: 03/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 MEDICAL PARK DR E STE 215
BIRMINGHAM AL
35235-3424
US

IV. Provider business mailing address

52 MEDICAL PARK DR E SUITE 207
BIRMINGHAM AL
35235-3430
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-3740
  • Fax: 205-838-3845
Mailing address:
  • Phone: 205-838-3740
  • Fax: 205-838-3845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number00014623
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: