Provider Demographics
NPI:1750386827
Name:WILLIAMS, BURSON T III (MD)
Entity type:Individual
Prefix:DR
First Name:BURSON
Middle Name:T
Last Name:WILLIAMS
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:7111 FAIRWAY DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-4204
Mailing Address - Country:US
Mailing Address - Phone:800-330-6565
Mailing Address - Fax:561-712-7349
Practice Address - Street 1:3918 MONTCLAIR RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-2425
Practice Address - Country:US
Practice Address - Phone:205-870-4897
Practice Address - Fax:205-871-4709
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2011-03-10
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Provider Licenses
StateLicense IDTaxonomies
AL14510207ZP0102X
ALMD.14510207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA297832854AMedicaid