Provider Demographics
NPI:1720065535
Name:WILLIAMS, LAWRENCE T (DO)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:T
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 242848
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36124-2848
Mailing Address - Country:US
Mailing Address - Phone:334-270-9914
Mailing Address - Fax:334-270-3195
Practice Address - Street 1:1808 W 2ND ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1504
Practice Address - Country:US
Practice Address - Phone:334-263-3344
Practice Address - Fax:334-263-9518
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL04-00968OtherUNITED HEALTHCARE
AL000027084Medicaid
AL04-00968OtherUNITED HEALTHCARE
AL000017995Medicare PIN