Healthcare Provider Details

I. General information

NPI: 1568484335
Provider Name (Legal Business Name): WILLIAM CRAIG VAN CLEAVE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 NEWBY RD SW
HUNTSVILLE AL
35805-4222
US

IV. Provider business mailing address

2603 NEWBY RD SW
HUNTSVILLE AL
35805-4222
US

V. Phone/Fax

Practice location:
  • Phone: 256-755-6967
  • Fax: 256-755-6961
Mailing address:
  • Phone: 256-755-6967
  • Fax: 256-755-6961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number28980
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: