MEDICARE: DR. WILLIAM W. WOODS III DMD

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
1	1223G0001X	General Practice Dentistry	2000-82	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	64-0709932	OTHER	MS	FEDERAL TAX ID #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548343148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM W. WOODS III DMD

Provider Business Mailing Address
First Line	:	4503 POPLAR SPRINGS DR
Second Line	:
City	:	MERIDIAN
State	:	MS
Zip	:	39305-2617
Country	:	US
Telephone Number	:	601-693-3200
Fax Number	:	601-482-1158

Provider Business Practice Location Address
First Line	:	4503 POPLAR SPRINGS DR
Second Line	:
City	:	MERIDIAN
State	:	MS
Zip	:	39305-2617
Country	:	US
Telephone Number	:	601-693-3200
Fax Number	:	601-482-1158

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	07/08/2007

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