MEDICARE: MR. WILLIAM F REID CRNA

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	367500000X	Certified Registered Nurse Anesthetist	R792327	MS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	430078861	OTHER	MS	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	331003463	OTHER	MS	TAX ID#
3	640901082	OTHER	MS	TAX ID#

General Provider Information

NPI Number	:	1851332209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM F REID CRNA

Provider Business Mailing Address
First Line	:	2005 HWY 82 WEST
Second Line	:
City	:	GREENWOOD
State	:	MS
Zip	:	38930
Country	:	US
Telephone Number	:	662-455-4523
Fax Number	:	662-455-3790

Provider Business Practice Location Address
First Line	:	2005 HWY 82 WEST
Second Line	:
City	:	GREENWOOD
State	:	MS
Zip	:	38930
Country	:	US
Telephone Number	:	662-455-4523
Fax Number	:	662-455-3790

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	07/08/2011

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Directions to “ MR. WILLIAM F REID CRNA” Practice Location

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