MEDICARE: DR. WILLIAM ELLIS SUMNERS MD

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	208000000X	Pediatrics Physician	6634	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407826837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM ELLIS SUMNERS MD

Provider Business Mailing Address
First Line	:	2161 NORMANDIE DR
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36111-2728
Country	:	US
Telephone Number	:	334-288-8222
Fax Number	:	334-284-2018

Provider Business Practice Location Address
First Line	:	2161 NORMANDIE DR
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36111-2728
Country	:	US
Telephone Number	:	334-288-8222
Fax Number	:	334-284-2018

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

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	08/23/2011

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