Provider Demographics
NPI:1932183217
Name:HIXSON, WILLIAM CARROLL (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CARROLL
Last Name:HIXSON
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:PO BOX 40430
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36640-0430
Mailing Address - Country:US
Mailing Address - Phone:251-434-3626
Mailing Address - Fax:251-445-2464
Practice Address - Street 1:1047 FAIRHOPE AVE
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-3145
Practice Address - Country:US
Practice Address - Phone:251-990-1850
Practice Address - Fax:251-990-1851
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.158562085R0001X
FLME734682085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009946795Medicaid
AL051557246Medicaid
AL510-46494OtherBCBS DAPHNE
AL51032527OtherBCBS FOLEY
AL515-33480OtherBCBS GULF SHORES
AL000032526Medicaid
AL990008217OtherRR MEDICARE SARO
ALP00317625OtherRR MEDICARE GS
AL000032527Medicaid
FL266724000OtherACS FL MEDICAID
AL515-22793OtherBCBS MONROEVILLE
AL51592672OtherBCBS BREWTON
ALP00190938OtherRR MEDICARE MNR
ALP00190938OtherRR MEDICARE MNR
ALP00317625OtherRR MEDICARE GS
FL266724000OtherACS FL MEDICAID
AL009946795Medicaid
AL000032526Medicaid