Provider Demographics
NPI:1174587257
Name:COLLIGNON, WILLIAM A JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:COLLIGNON
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:501 E DR HICKS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630
Mailing Address - Country:US
Mailing Address - Phone:256-383-0423
Mailing Address - Fax:256-383-0922
Practice Address - Street 1:501 EAST DR HICKS BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630
Practice Address - Country:US
Practice Address - Phone:256-383-0423
Practice Address - Fax:256-383-0922
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2020-05-12
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Provider Licenses
StateLicense IDTaxonomies
AL00011307208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051556653Medicaid
AL051556653Medicaid
ALC70634Medicare UPIN