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General NPI Number Information
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NPI Number | 1194539312
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Entity Type | Individual
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Provider Name | WILLIAM TEAGUE
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Gender | Male
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 400 E 10TH ST
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City | ANNISTON
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State | AL
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Zip | 36207-4716
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Country | US
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Telephone | 256-235-5121
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Fax |
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Provider Business Mailing Address
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Address Line | 2225 MADISON LOOP
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City | SOUTHSIDE
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State | AL
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Zip | 35907-7206
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Country | US
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Telephone | 256-295-8909
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-181840
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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