Healthcare Provider Details

I. General information

NPI: 1467503615
Provider Name (Legal Business Name): DRAKE B. WILLIAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 04/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 US HIGHWAY 90 SUITE 101
DAPHNE AL
36526-9512
US

IV. Provider business mailing address

805 SAINT VINCENTS DR SUITE 510
BIRMINGHAM AL
35205-1636
US

V. Phone/Fax

Practice location:
  • Phone: 251-625-8222
  • Fax: 251-625-8117
Mailing address:
  • Phone: 205-595-5504
  • Fax: 205-592-3427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD19431
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: