Organization
FORMWALT AND WILLIAMS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JOYELLE REED (OFFICE MANAGER)
(251) 776-1217
Entity
Organization
Contact information
Practice address
7305 COTTAGE HILL ROAD, MOBILE, AL 36695
(251) 776-1217
(251) 776-1219
Mailing address
POST OFFICE BOX 850818, MOBILE, AL 36685-0818
(251) 776-1217
(251) 776-1219
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
504
AL
103TC0700X
Clinical Psychologist
593
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R38382
BC & BS DR ANNIE FORMWALT
—
01
—
R82618
BCBS DR LUCILE T WILLIAMS
—
Enumeration date
10/03/2006
Last updated
09/17/2010
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