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General NPI Number Information
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NPI Number | 1013110006
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Entity Type | Individual
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Provider Name | WILLIAM EDWARD LIEVENS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 6001 E SHIRLEY LN
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City | MONTGOMERY
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State | AL
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Zip | 36117-1935
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Country | US
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Telephone | 334-244-1618
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 MIDFIELD DR
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City | MONTGOMERY
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State | AL
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Zip | 36111-1529
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Country | US
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Telephone | 334-239-2838
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 29280
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 29280
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 29280
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | 29280
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License Number State | AL
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Taxonomy #5
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number | 29280
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License Number State | AL
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Taxonomy #6
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Taxonomy Code | 273100000X
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Taxonomy Name | Epilepsy Hospital Unit
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License Number | 29280
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License Number State | AL
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Taxonomy #7
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 29280
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License Number State | AL
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