Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 7019 | AL |
NPI | 1053303602 |
---|---|
Provider Name | Dr. William Gary Cumbie JR. |
First Address | Montgomery, AL 36106-1103 |
Second Address | Montgomery, AL 36106-1103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2005 |
Last Update Date | 19/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000016409 | (05) | AL |
16409 | BCBS (01) | AL |
C73225 | (02) |