Healthcare Provider Details

I. General information

NPI: 1023202074
Provider Name (Legal Business Name): WILLIAM C ASHFORD M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 07/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 BAPTIST DR SUITE 220
MADISON MS
39110-2030
US

IV. Provider business mailing address

501 BAPTIST DR SUITE 220
MADISON MS
39110-2030
US

V. Phone/Fax

Practice location:
  • Phone: 601-985-9120
  • Fax: 601-985-9122
Mailing address:
  • Phone: 601-985-9120
  • Fax: 601-985-9122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number07279
License Number StateMS

VIII. Authorized Official

Name: DR. WILLIAM C ASHFORD
Title or Position: OWNER
Credential: M.D.
Phone: 601-985-9120