Provider Demographics
NPI:1356786669
Name:RASBERRY, WILLIAM M JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:RASBERRY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:MILLSAPS
Other - Last Name:RASBERRY
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1912 AL HIGHWAY 157
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058-0609
Mailing Address - Country:US
Mailing Address - Phone:256-737-2000
Mailing Address - Fax:256-737-2152
Practice Address - Street 1:1912 AL HIGHWAY 157
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-0609
Practice Address - Country:US
Practice Address - Phone:256-737-2682
Practice Address - Fax:256-737-2152
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN51929207R00000X, 207RA0401X
MS28169207R00000X
ALMD.41981208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL287558Medicaid
TNQ021340Medicaid