Provider Demographics
NPI:1376994376
Name:WILLIAMS, EDWARD DICKSON (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:DICKSON
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1410 SOUTH HICKORY STREET
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535
Mailing Address - Country:US
Mailing Address - Phone:251-428-2477
Mailing Address - Fax:251-862-8162
Practice Address - Street 1:8531 SPANISH FORT BLVD
Practice Address - Street 2:
Practice Address - City:SPANISH FORT
Practice Address - State:AL
Practice Address - Zip Code:36527
Practice Address - Country:US
Practice Address - Phone:251-428-2477
Practice Address - Fax:251-862-8162
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.38564207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL236670Medicaid
AL512-22261OtherBCBS ALABAMA