Healthcare Provider Details
I. General information
NPI: 1568556280
Provider Name (Legal Business Name): WILLIAM PEYTON SHIRLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/03/2006
Last Update Date: 11/16/2024
Certification Date: 11/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5406 HIGHWAY 280 SUITE A101
BIRMINGHAM AL
35242
US
IV. Provider business mailing address
5406 HIGHWAY 280 SUITE A101
BIRMINGHAM AL
35242
US
V. Phone/Fax
- Phone: 205-874-9436
- Fax: 205-874-9438
- Phone: 205-874-9436
- Fax: 205-874-9438
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207YP0228X |
| Taxonomy | Pediatric Otolaryngology Physician |
| License Number | 22947 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: