Healthcare Provider Details

I. General information

NPI: 1952365587
Provider Name (Legal Business Name): DONALD BRYANT WILLIAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 02/03/2020
Certification Date: 02/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 3RD AVE S STE 101
JASPER AL
35501-5399
US

IV. Provider business mailing address

2090 COLUMBIANA RD SUITE 4400
BIRMINGHAM AL
35216-2153
US

V. Phone/Fax

Practice location:
  • Phone: 205-775-0300
  • Fax:
Mailing address:
  • Phone: 205-824-8000
  • Fax: 205-824-8111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number7014
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number7014
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number7014
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: