Healthcare Provider Details

I. General information

NPI: 1285184994
Provider Name (Legal Business Name): THOMAS WILLIAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2016
Last Update Date: 10/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 LEACH DR
BIRMINGHAM AL
35213-2709
US

IV. Provider business mailing address

305 LEACH DR
BIRMINGHAM AL
35213-2709
US

V. Phone/Fax

Practice location:
  • Phone: 205-266-7304
  • Fax:
Mailing address:
  • Phone: 205-266-7304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: