MEDICARE: DR. WILLIAM C LOPEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	1088	AL

General Provider Information

NPI Number	:	1013998228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM C LOPEZ M.D.

Provider Business Mailing Address
First Line	:	100 PILOT MEDICAL DR
Second Line	:	SUITE 225
City	:	BIRMINGHAM
State	:	AL
Zip	:	35235-3411
Country	:	US
Telephone Number	:	205-854-8404
Fax Number	:	205-854-4302

Provider Business Practice Location Address
First Line	:	100 PILOT MEDICAL DR
Second Line	:	SUITE 225
City	:	BIRMINGHAM
State	:	AL
Zip	:	35235-3411
Country	:	US
Telephone Number	:	205-854-8404
Fax Number	:	205-854-4302

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	10/05/2011

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