Provider Demographics
NPI:1578183323
Name:NICOLSON, WILLIAM BERNEY CAINE (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BERNEY CAINE
Last Name:NICOLSON
Suffix:
Gender:
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 55309
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 SAINT VINCENTS DR STE 600
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1630
Practice Address - Country:US
Practice Address - Phone:205-933-9258
Practice Address - Fax:205-933-6504
Is Sole Proprietor?:No
Enumeration Date:2020-04-22
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.43740207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine