MEDICARE: DR. WILLIAM BROOKS HERRON 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	207R00000X	Internal Medicine Physician	30904	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	:	1962685958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM BROOKS HERRON M.D.

Provider Business Mailing Address
First Line	:	150 S INGLESIDE ST STE 6
Second Line	:
City	:	FAIRHOPE
State	:	AL
Zip	:	36532-1804
Country	:	US
Telephone Number	:	251-990-1740
Fax Number	:	251-990-1831

Provider Business Practice Location Address
First Line	:	150 S INGLESIDE ST STE 6
Second Line	:
City	:	FAIRHOPE
State	:	AL
Zip	:	36532-1804
Country	:	US
Telephone Number	:	251-990-1740
Fax Number	:	251-990-1831

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

Provider Enumeration Date	:	12/12/2007
Last Update Date	:	03/15/2023

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