Provider Demographics
NPI:1679542740
Name:WILLIAMS, MICHAEL A (DO)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 6599
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36302-6599
Mailing Address - Country:US
Mailing Address - Phone:334-793-2120
Mailing Address - Fax:334-671-0228
Practice Address - Street 1:144 VIRGINIA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:DALEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36322-2306
Practice Address - Country:US
Practice Address - Phone:334-503-9900
Practice Address - Fax:334-598-1827
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2020-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ALDO-361207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC02967Medicare UPIN