Healthcare Provider Details

I. General information

NPI: 1699159483
Provider Name (Legal Business Name): WILLIAM RUDOLPHUS HALLMAN JR. RNFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2015
Last Update Date: 07/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7925 BRADLEY RD
DUNCANVILLE AL
35456-1923
US

IV. Provider business mailing address

7925 BRADLEY RD
DUNCANVILLE AL
35456-1923
US

V. Phone/Fax

Practice location:
  • Phone: 205-826-4745
  • Fax:
Mailing address:
  • Phone: 205-826-4745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number1-088992
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: