Provider Demographics
NPI:1023335312
Name:WILLIAMS, TIMOTHY ALPHONZO (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:ALPHONZO
Last Name:WILLIAMS
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 1:817 PRINCETON AVE SW
Mailing Address - Street 2:POB II; SUITE 210
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-1333
Mailing Address - Country:US
Mailing Address - Phone:205-788-7572
Mailing Address - Fax:205-226-5938
Practice Address - Street 1:35 W LAKESHORE DR STE 200
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-7250
Practice Address - Country:US
Practice Address - Phone:205-226-5900
Practice Address - Fax:205-226-5937
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL31432207RN0300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program