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General NPI Number Information
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NPI Number | 1578026100
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Entity Type | Individual
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Provider Name | WILLIAM BRADFORD FANCHER
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Gender | Male
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Dates
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Enumeration Date | 04/10/2019
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 504 BROOKWOOD BLVD
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City | BIRMINGHAM
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State | AL
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Zip | 35209-6802
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Country | US
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Telephone | 205-871-9661
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 LEGACY DR STE 100
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City | FRISCO
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State | TX
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Zip | 75034-5984
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Country | US
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Telephone |
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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 | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | MD.42090
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License Number State | AL
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