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NPI Code Detail

MEDICARE: DR. WILLIAM LLOYD BOOKER MD

MEDICARE: DR. WILLIAM LLOYD BOOKER 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
1207Q00000XFamily Medicine Physician10660MS

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 : 1720087521
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM LLOYD BOOKER MD
Provider Business Mailing Address
First Line : 510 HIGHWAY 322
Second Line : P O BOX 1216
City : CLARKSDALE
State : MS
Zip : 38614-4717
Country : US
Telephone Number : 662-624-4292
Fax Number : 662-624-4354
Provider Business Practice Location Address
First Line : 800 OHIO AVE
Second Line :
City : CLARKSDALE
State : MS
Zip : 38614-7200
Country : US
Telephone Number : 662-624-2504
Fax Number : 662-627-3629
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 04/04/2011

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Directions to “ DR. WILLIAM LLOYD BOOKER MD” Practice Location

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