1295764124 NPI number — WILLIAM E ADMIRE JR. DO

Table of content: WILLIAM E ADMIRE JR. DO (NPI 1295764124)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295764124 NPI number — WILLIAM E ADMIRE JR. DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADMIRE
Provider First Name:
WILLIAM
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
JR.
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295764124
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3280 DAUPHIN ST
Provider Second Line Business Mailing Address:
BUILDING B, SUTE 118
Provider Business Mailing Address City Name:
MOBILE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36606-4060
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-454-4579
Provider Business Mailing Address Fax Number:
251-287-1466

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 MOBILE INFIRMARY CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOBILE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36607-3513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-545-4579
Provider Business Practice Location Address Fax Number:
251-287-1466
Provider Enumeration Date:
07/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  DO.340 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207PE0004X , with the licence number: DO-340 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: DO.340 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: DO.340 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: DO.340 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000008235 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 510-48739 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 009936158 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009991575 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 515-33010 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 515-33040 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 510-48738 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 511-16533 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 511-16534 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 009936156 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009936157 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 515-33011 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 510-08235 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 511-16535 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 151881 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009938389 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1295764124 . This is a "TRICARE SOUTH" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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