Provider Demographics
NPI:1134365372
Name:HARIGEL, WILLIAM SHANE (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:SHANE
Last Name:HARIGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:WILLIAM
Other - Middle Name:SHANE
Other - Last Name:HARIGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:402 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:ATMORE
Mailing Address - State:AL
Mailing Address - Zip Code:36502-3004
Mailing Address - Country:US
Mailing Address - Phone:251-368-7974
Mailing Address - Fax:251-368-5973
Practice Address - Street 1:402 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:ATMORE
Practice Address - State:AL
Practice Address - Zip Code:36502-3004
Practice Address - Country:US
Practice Address - Phone:251-368-7974
Practice Address - Fax:251-368-5973
Is Sole Proprietor?:No
Enumeration Date:2008-12-17
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN13461207Q00000X
ALMD31834207Q00000X
AL1-092152363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily