Provider Demographics
NPI:1588602601
Name:WILLIAMS, MARK S (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:S
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 55059
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5059
Mailing Address - Country:US
Mailing Address - Phone:256-764-9697
Mailing Address - Fax:256-764-9699
Practice Address - Street 1:1600 CARRAWAY BLVD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35234-1913
Practice Address - Country:US
Practice Address - Phone:205-502-6817
Practice Address - Fax:205-502-5152
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL00009797207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC71619Medicare UPIN