Provider Demographics
NPI:1992876114
Name:TAPSCOTT, WILLIAM J (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:TAPSCOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55361
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5361
Mailing Address - Country:US
Mailing Address - Phone:205-933-6440
Mailing Address - Fax:205-933-6442
Practice Address - Street 1:2700 10TH AVE S
Practice Address - Street 2:SUITE 402
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1200
Practice Address - Country:US
Practice Address - Phone:205-933-6440
Practice Address - Fax:205-933-6442
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19818208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102I028097OtherMEDICARE PTAN
AL009931894Medicaid
AL000078442Medicaid
AL75660Medicare ID - Type Unspecified
AL009931896Medicare ID - Type Unspecified
AL78442Medicare ID - Type Unspecified
AL000078442Medicaid
G82405Medicare UPIN