Provider Demographics
NPI:1578735510
Name:WILLIAMS, LIZA CRAVEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:LIZA
Middle Name:CRAVEN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 MARKLUND RD
Mailing Address - Street 2:
Mailing Address - City:SUMITON
Mailing Address - State:AL
Mailing Address - Zip Code:35148-3936
Mailing Address - Country:US
Mailing Address - Phone:205-648-0317
Mailing Address - Fax:
Practice Address - Street 1:1721 HIGHWAY 31 NORTH
Practice Address - Street 2:
Practice Address - City:FULTONDALE
Practice Address - State:AL
Practice Address - Zip Code:35068
Practice Address - Country:US
Practice Address - Phone:205-841-2021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15532183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist