Healthcare Provider Details

I. General information

NPI: 1881952489
Provider Name (Legal Business Name): WILLIAM STANLEY HAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 08/25/2023
Certification Date: 08/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 BROOKMAN DR
BROOKHAVEN MS
39601-2326
US

IV. Provider business mailing address

PO BOX 620
BROOKHAVEN MS
39602-0620
US

V. Phone/Fax

Practice location:
  • Phone: 601-833-7973
  • Fax:
Mailing address:
  • Phone: 601-833-7973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.206534
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number23749
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: