Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | 284 | AL |
Y | 2081S0010X | Sports Medicine | 284 | AL |
Y | 213ES0000X | Sports Medicine | 284 | AL |
N | 213ES0131X | Foot Surgery | 284 | AL |
NPI | 1174634000 |
---|---|
Provider Name | Marvin Earl Williams JR. |
First Address | Anniston, AL 36202-2127 |
Second Address | Anniston, AL 36207-5782 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 13/10/2016 |