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NPI Code Detail

MEDICARE: WILLIAM R. FELLOWS, MD

MEDICARE: WILLIAM R. FELLOWS, MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RA0401XAddiction Medicine (Internal Medicine) Physician08239MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306840871
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILLIAM R. FELLOWS, MD
Provider Business Mailing Address
First Line : 180 DEBUYS RD
Second Line : STE 130
City : BILOXI
State : MS
Zip : 39531-4402
Country : US
Telephone Number : 228-388-7770
Fax Number :
Provider Business Practice Location Address
First Line : 180 DEBUYS RD
Second Line : STE 130
City : BILOXI
State : MS
Zip : 39531-4402
Country : US
Telephone Number : 228-388-7770
Fax Number :
Authorized Official
Title or Position : OWNER
Name : WILLIAM R FELLOWS
Credential : M.D.
Telephone Number : 228-388-7770
Provider Enumeration Date : 06/11/2005
Last Update Date : 09/10/2008

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Directions to “WILLIAM R. FELLOWS, MD ” Practice Location

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