Healthcare Provider Details

I. General information

NPI: 1144242918
Provider Name (Legal Business Name): WILLIAM W MINGS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 SOUTH ST
ANNA IL
62906
US

IV. Provider business mailing address

PO BOX 548
ANNA IL
62906
US

V. Phone/Fax

Practice location:
  • Phone: 618-833-8551
  • Fax:
Mailing address:
  • Phone: 618-833-8551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: