=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578673919
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WILLIAM DAVID STINSON M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2006
-----------------------------------------------------
Last Update Date | 03/25/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 315 WALNUT BEND SOUTH
-----------------------------------------------------
City | CORDOVA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38018-7216
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-755-8880
-----------------------------------------------------
Fax | 901-755-8366
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 315 WALNUT BEND SOUTH
-----------------------------------------------------
City | CORDOVA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38018-7216
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-755-8880
-----------------------------------------------------
Fax | 901-755-8366
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 30219
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | BS5820457
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------