Provider Demographics
NPI:1275778615
Name:WILLIAMS, BRUCE ARNOLD (MD)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:ARNOLD
Last Name:WILLIAMS
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 1:535 OREGON STREET
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35224-1834
Mailing Address - Country:US
Mailing Address - Phone:205-370-4099
Mailing Address - Fax:
Practice Address - Street 1:535 OREGON STREET
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35224-1834
Practice Address - Country:US
Practice Address - Phone:205-370-4099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10995207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC78621Medicare UPIN