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General NPI Number Information
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NPI Number | 1679628127
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Entity Type | Organization
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Legal Business Name | WILLIAM M. STEELY
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 575 MALL BLVD SUITE L2
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City | DYERSBURG
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State | TN
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Zip | 38024-1661
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Country | US
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Telephone | 731-285-3338
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Fax | 731-286-6331
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Provider Business Mailing Address
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Address Line | 575 MALL BLVD SUITE L2
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City | DYERSBURG
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State | TN
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Zip | 38024-1661
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Country | US
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Telephone | 731-285-3338
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Fax | 731-286-6331
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Authorized Official
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Title or Position | OWNER DOCTOR
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Name | WILLIAM M STEELY
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Credential | DPM
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Telephone | 731-285-3338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | DPM0000000571
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License Number State | TN
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