Provider Demographics
NPI:1124708409
Name:BOMAR, WILLIAM FRANK JR (LMSW)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FRANK
Last Name:BOMAR
Suffix:JR
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2804 8TH ST
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2108
Mailing Address - Country:US
Mailing Address - Phone:205-523-4024
Mailing Address - Fax:
Practice Address - Street 1:2804 8TH ST
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-2108
Practice Address - Country:US
Practice Address - Phone:205-523-4024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6302G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker