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NPI Code Detail

MEDICARE: WILLIAM B ABBOTT III MD

MEDICARE: WILLIAM B ABBOTT III 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
12085R0202XDiagnostic Radiology Physician060031GA
2174400000XSpecialist18620AL

General Provider Information

NPI Number : 1760489744
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM B ABBOTT III MD
Provider Business Mailing Address
First Line : 2000A SOUTHBRIDGE PKWY
Second Line : STE 300
City : BIRMINGHAM
State : AL
Zip : 35209-7704
Country : US
Telephone Number : 205-871-4274
Fax Number : 205-871-4301
Provider Business Practice Location Address
First Line : 417 W 3RD AVE
Second Line :
City : ALBANY
State : GA
Zip : 31701-1943
Country : US
Telephone Number : 229-312-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 03/17/2018

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