William C. Booth Jr., PA-C
Individual provider Active NPI Physician Assistant · Biloxi, MS
NPI 1104841113 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104841113
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 400 Veterans Ave
Biloxi, MS 39531-2410 - Phone
- (228) 523-4762
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
400 Veterans Ave
Biloxi, MS 39531-2410
Mailing address
863 Laurelwood Dr
Biloxi, MS 39532-4249
Phone (228) 388-6593
Other providers in Biloxi, MS
- Hasani K Bolden
- Kayla Bolt
- Bond and Bloom Counseling, PLLC
- Robert J Bonhomme
- Skylar Jo Freeman Boose
- Alexandria Borden
- Andrew Borho
- Kaitlin Borri
- Susan Boston
- Karen R Boswell
All providers in Biloxi, MS · Physician Assistant in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.