Provider Demographics
NPI:1013110006
Name:LIEVENS, WILLIAM EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EDWARD
Last Name:LIEVENS
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 1:2400 MIDFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36111-1529
Mailing Address - Country:US
Mailing Address - Phone:334-239-2838
Mailing Address - Fax:
Practice Address - Street 1:6001 E SHIRLEY LN
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-1935
Practice Address - Country:US
Practice Address - Phone:334-244-1618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29280174400000X, 2084A0401X, 2084N0600X, 2084S0012X, 261QM2800X, 273100000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No174400000XOther Service ProvidersSpecialist
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No273100000XHospital UnitsEpilepsy Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL29280OtherALABAMA STATE BOARD OF MEDICAL EXAMINERS, CONTROLLED SUBSTANCES REGISTRATION
AL3634532OtherUNITED HEALTH CARE
57026OtherBOARD CERTIFIED IN NEUROLOGY, AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY
ALMD.29280OtherALABAMA MEDICAL LICENSURE COMMISSION
AL511-36880OtherBLUE ADVANTAGE
AL150070Medicaid
AL4448615OtherCIGNA
AL511-36880OtherBLUE CROSS/BLUE SHIELD OF ALABAMA
AL12562126OtherCAQH
ALXXXXX9748OtherTRICARE / HUMANA MILITARY
ALXXXXX9748OtherTRICARE / HUMANA MILITARY
ALXXXXX9748OtherTRICARE / HUMANA MILITARY
AL511-36880OtherBLUE CROSS/BLUE SHIELD OF ALABAMA