Healthcare Provider Details

I. General information

NPI: 1023218351
Provider Name (Legal Business Name): WILLIAM MCIVER LEPPARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 02/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 LAUREL ST STE 200
COLUMBIA SC
29204-2047
US

IV. Provider business mailing address

330 SEVEN SPRINGS WAY
BRENTWOOD TN
37027-5098
US

V. Phone/Fax

Practice location:
  • Phone: 803-409-7130
  • Fax: 803-252-8280
Mailing address:
  • Phone: 615-920-7878
  • Fax: 615-920-8775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number29995
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number29995
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: