Provider Demographics
NPI:1801897269
Name:WILLIAMS, ROBERT MCLAIN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MCLAIN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:103 E MEMORIAL AVE
Mailing Address - Street 2:PHYSICIANS OFFICE BUILDING
Mailing Address - City:OPP
Mailing Address - State:AL
Mailing Address - Zip Code:36467-1704
Mailing Address - Country:US
Mailing Address - Phone:334-493-7930
Mailing Address - Fax:334-493-3384
Practice Address - Street 1:103 E MEMORIAL AVE
Practice Address - Street 2:PHYSICIANS OFFICE BUILDING
Practice Address - City:OPP
Practice Address - State:AL
Practice Address - Zip Code:36467-1704
Practice Address - Country:US
Practice Address - Phone:334-493-7930
Practice Address - Fax:334-493-3384
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL00013653207Q00000X
IDM-8671207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000017551Medicaid
C72910Medicare UPIN
051017551Medicare ID - Type Unspecified