Healthcare Provider Details

I. General information

NPI: 1801845060
Provider Name (Legal Business Name): WILLIAM H MEYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 03/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 HIGHWAY 51 N
BROOKHAVEN MS
39601-2350
US

IV. Provider business mailing address

1075 HAWTHORNE DR
MCCOMB MS
39648-7568
US

V. Phone/Fax

Practice location:
  • Phone: 601-835-9468
  • Fax: 601-878-2011
Mailing address:
  • Phone: 601-835-9468
  • Fax: 601-878-2011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License Number05473
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: