Healthcare Provider Details

I. General information

NPI: 1184652554
Provider Name (Legal Business Name): WILLIAM WATKINS PRYOR JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6439 GARNERS FERRY RD
COLUMBIA SC
29209-1638
US

IV. Provider business mailing address

330 STEEPLE CRST N
IRMO SC
29063-9257
US

V. Phone/Fax

Practice location:
  • Phone: 803-791-4000
  • Fax:
Mailing address:
  • Phone: 803-732-3765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number11101
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number11101
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: