Provider Demographics
NPI:1992762231
Name:WILLIAMS, DEBRA L (DO)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1015 AIRPORT RD SW STE 204
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-1394
Mailing Address - Country:US
Mailing Address - Phone:256-883-7031
Mailing Address - Fax:256-883-7032
Practice Address - Street 1:1015 AIRPORT RD SW STE 204
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-1394
Practice Address - Country:US
Practice Address - Phone:256-883-7031
Practice Address - Fax:256-883-7032
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO 7642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
BW4410421OtherDEA NUMBER
BW4410421OtherDEA NUMBER