Healthcare Provider Details

I. General information

NPI: 1750098901
Provider Name (Legal Business Name): WILLIAM H BOYCE III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 SKYLINE DR
JACKSON TN
38301-3923
US

IV. Provider business mailing address

620 SKYLINE DR
JACKSON TN
38301-3923
US

V. Phone/Fax

Practice location:
  • Phone: 731-425-5000
  • Fax:
Mailing address:
  • Phone: 731-425-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number77650
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: