Healthcare Provider Details

I. General information

NPI: 1104345222
Provider Name (Legal Business Name): WILLIAM ALEXANDER WOODARD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2017
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3980 COLONNADE PKWY STE 102
BIRMINGHAM AL
35243-2382
US

IV. Provider business mailing address

3500 BLUE LAKE DR STE 495
VESTAVIA AL
35243-1975
US

V. Phone/Fax

Practice location:
  • Phone: 205-977-8484
  • Fax: 205-977-2173
Mailing address:
  • Phone: 205-977-8484
  • Fax: 205-977-2173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-134184
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-134184
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: