Provider Demographics
NPI:1760442388
Name:ABERNATHY, WILLIAM ABE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ABE
Last Name:ABERNATHY
Suffix:JR
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 1:101 S UNION ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36130-3022
Mailing Address - Country:US
Mailing Address - Phone:334-263-6470
Mailing Address - Fax:
Practice Address - Street 1:2029 NORMANDIE DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36111-2711
Practice Address - Country:US
Practice Address - Phone:334-612-0391
Practice Address - Fax:334-612-0394
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7693174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000006559Medicaid
ALC71916Medicare UPIN
AL000006559Medicaid