Provider Demographics
NPI:1659326932
Name:AUGUST, BILLY (MD)
Entity type:Individual
Prefix:
First Name:BILLY
Middle Name:
Last Name:AUGUST
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 1:8250 BAY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-9055
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1851 N MCKENZIE ST
Practice Address - Street 2:SUITE 206
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-4700
Practice Address - Country:US
Practice Address - Phone:251-943-8515
Practice Address - Fax:251-943-4532
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00009675207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC73011Medicare UPIN
FL55565Medicare ID - Type Unspecified