Provider Demographics
NPI:1407826837
Name:SUMNERS, WILLIAM ELLIS (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ELLIS
Last Name:SUMNERS
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 1:2161 NORMANDIE DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36111-2728
Mailing Address - Country:US
Mailing Address - Phone:334-288-8222
Mailing Address - Fax:334-284-2018
Practice Address - Street 1:2161 NORMANDIE DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36111-2728
Practice Address - Country:US
Practice Address - Phone:334-288-8222
Practice Address - Fax:334-284-2018
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6634208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000084065Medicaid
AL000084065Medicaid