Healthcare Provider Details

I. General information

NPI: 1407943848
Provider Name (Legal Business Name): WILLIAM PARSONS GIFFORD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 01/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1353 GERMANY RD
WILLIAMSTON MI
48895-9610
US

IV. Provider business mailing address

1353 GERMANY RD
WILLIAMSTON MI
48895-9610
US

V. Phone/Fax

Practice location:
  • Phone: 517-655-3523
  • Fax:
Mailing address:
  • Phone: 517-655-3523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301040023
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: