Provider Demographics
NPI:1053303602
Name:CUMBIE, WILLIAM GARY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GARY
Last Name:CUMBIE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 PINE ST
Mailing Address - Street 2:STE 500
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1103
Mailing Address - Country:US
Mailing Address - Phone:334-264-9500
Mailing Address - Fax:334-264-9519
Practice Address - Street 1:1722 PINE ST
Practice Address - Street 2:STE 500
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1103
Practice Address - Country:US
Practice Address - Phone:334-264-9500
Practice Address - Fax:334-264-9519
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7019207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000016409Medicaid
AL16409OtherBCBS
AL000016409Medicaid
000016409Medicare ID - Type Unspecified