Healthcare Provider Details

I. General information

NPI: 1144262775
Provider Name (Legal Business Name): WILLIAM ERHARD EYRING III PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 N COURTENAY PKWY STE 206
MERRITT ISLAND FL
32953
US

IV. Provider business mailing address

1395 N COURTENAY PKWY STE 206
MERRITT ISLAND FL
32953
US

V. Phone/Fax

Practice location:
  • Phone: 321-459-1003
  • Fax: 321-459-1006
Mailing address:
  • Phone: 321-459-1003
  • Fax: 321-459-1006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY6297
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: