Provider Demographics
NPI:1073509857
Name:EHRLICH, WILLIAM W (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:W
Last Name:EHRLICH
Suffix:
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 1:250 STATE FARM PKWY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7181
Mailing Address - Country:US
Mailing Address - Phone:205-943-4600
Mailing Address - Fax:205-943-4660
Practice Address - Street 1:250 STATE FARM PKWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-7181
Practice Address - Country:US
Practice Address - Phone:205-943-4600
Practice Address - Fax:205-943-4660
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301043309174400000X
FLME126065207W00000X
ALMD.43248207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No174400000XOther Service ProvidersSpecialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016026200Medicaid
FLMGXP0OtherBC FLORIDA
FLP01599482OtherRAIL ROAD MEDICARE
FLII830YMedicare PIN
FLII830ZMedicare PIN
FLII830ZMedicare PIN
FLMGXP0OtherBC FLORIDA
MIA74882Medicare UPIN
MI180028406OtherRAILROAD MEDICARE
FLII830YMedicare PIN