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NPI Code Detail

MEDICARE: WILLIAM BANKS MANGOLD

MEDICARE: WILLIAM BANKS MANGOLD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1770370587
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM BANKS MANGOLD
Provider Business Mailing Address
First Line : 2101 BERRY PATCH RD
Second Line :
City : THOMPSONS STATION
State : TN
Zip : 37179-0020
Country : US
Telephone Number : 615-513-2471
Fax Number :
Provider Business Practice Location Address
First Line : 1031 NASDAQ ST
Second Line :
City : SPRING HILL
State : TN
Zip : 37174-4229
Country : US
Telephone Number : 615-560-6622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2025
Last Update Date : 04/23/2025

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Directions to “ WILLIAM BANKS MANGOLD ” Practice Location

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