Basic Information
| Provider Information | |||||||||
| NPI: | 1023321411 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PITTS | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | BRADLEY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7987 | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366700987 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516330573 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5955 AIRPORT BLVD | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 36608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516330573 | ||||||||
| FaxNumber: | 2516337367 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2010 | ||||||||
| LastUpdateDate: | 10/29/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 31904 | AL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | 31904 | AL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 390200000X | AL | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RP1001X | 31904 | AL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 102I291133 | 01 | AL | MEDICARE | OTHER | 199615 | 05 | AL | MEDICAID | 5427272 | 01 | AL | CIGNA HC | OTHER | 197983 | 05 | AL | MEDICAID | 2527030 | 01 | MS | MS MEDICAID | OTHER | 511-92369 | 01 | AL | BCBS | OTHER | 512-05755 | 01 | AL | BCBS | OTHER | Z22370 | 01 | AL | VIVA HEALTH | OTHER | 239801 | 05 | AL | MEDICAID | P01901960 | 01 | AL | RR MEDICARE | OTHER | 214400 | 05 | AL | MEDICAID | 511-92371 | 01 | AL | BCBS | OTHER | 197992 | 05 | AL | MEDICAID | 3661053 | 01 | AL | UHC | OTHER | 213097 | 05 | AL | MEDICAID | 511-92370 | 01 | AL | BCBS | OTHER | 4731200 | 01 | AL | AETNA | OTHER | 512-05756 | 01 | AL | BCBS | OTHER |