Provider Demographics
NPI:1073558458
Name:MCMAHON, WILLIAM STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:STEPHEN
Last Name:MCMAHON
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:PO BOX 55823
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5823
Mailing Address - Country:US
Mailing Address - Phone:205-934-3460
Mailing Address - Fax:
Practice Address - Street 1:1700 6TH AVE S
Practice Address - Street 2:SUITE 9100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1802
Practice Address - Country:US
Practice Address - Phone:205-934-3460
Practice Address - Fax:205-975-6291
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL148712080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E23348OtherVIVA
AL13264OtherHEALTHSPRING
E23348OtherVIVA
AL00121847OtherMISSISSIPPI MEDICAID
AL2510183OtherUHC
AL51036862OtherBC BS
E23348Medicare UPIN
AL2510183OtherUHC