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NPI Code Detail

MEDICARE: WILLIE WILLIAMS JR. M.D.

MEDICARE: WILLIE WILLIAMS JR. 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
1207R00000XInternal Medicine Physician11325AL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4110209683OTHERALRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1C23574OTHERALVIVA INSURANCE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5512-20081OTHERALBCBS AL
6C23574OTHERALHEALTHSPRING OF ALABAMA

General Provider Information

NPI Number : 1194788729
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIE WILLIAMS JR. M.D.
Provider Business Mailing Address
First Line : PO BOX 12366
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35202-2366
Country : US
Telephone Number : 205-788-6688
Fax Number : 205-788-0305
Provider Business Practice Location Address
First Line : 832 PRINCETON AVE SW
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35211-1320
Country : US
Telephone Number : 205-788-6688
Fax Number : 205-788-0305
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2006
Last Update Date : 03/04/2019

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Directions to “ WILLIE WILLIAMS JR. M.D.” Practice Location

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