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General NPI Number Information
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NPI Number | 1548441801
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Entity Type | Organization
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Legal Business Name | WILLIAM B. OLDS, MD, PA
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 11/11/2013
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Provider Practice Location Address
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Address Line | 757 CARVER DR
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City | ROXBORO
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State | NC
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Zip | 27573-4431
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Country | US
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Telephone | 336-597-5553
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Fax | 336-597-5034
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Provider Business Mailing Address
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Address Line | 757 CARVER DR
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City | ROXBORO
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State | NC
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Zip | 27573-4431
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Country | US
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Telephone | 336-597-5553
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Fax | 336-597-5034
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM BELLAMY OLDS
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Credential | MD
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Telephone | 336-597-5553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 26463
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License Number State | NC
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