Provider Information for 1356910236
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Mr. WILLIAM WEATHERS
Sex: Male
NPI: 1356910236
Last Updated: 2024-03-13
Certification Date: 2024-03-13
Certification Date: 2024-03-13
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1356910236 | ||||||||
| Enumeration Date | 2021-06-23 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 127 S COURT SQ OZARK, AL 36360-0401 United States Phone: 334-714-6494 | Fax: | ||||||||
| Primary Practice Address | 127 S COURT SQ OZARK, AL 36360-0401 United States Phone: 334-714-6494 | Fax: | ||||||||
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