Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 22820 | AL |
NPI | 1073599601 |
---|---|
Provider Name | Dr. William Bibb Lamar III |
First Address | Mobile, AL 36685-0849 |
Second Address | Mobile, AL 36608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 10/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051520133 | (05) | AL |
51520133 | BCBS (01) | AL |
H13443 | (02) | AL |