William Anthony Minor, IDC
Individual provider Active NPI Independent Duty Medical Technicians · SSC, MS
NPI 1306043641 · NPPES record last updated Aug 31, 2010
Key facts
- NPI
- 1306043641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Independent Duty Medical Technicians 1710I1003X
- Practice address
- 2603 Lower Gainsville Rd
Nattc SBT 22
SSC, MS 39529 - Phone
- (228) 813-4000
- NPI assigned
- Jun 29, 2007
- 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 |
|---|---|---|---|---|
| Independent Duty Medical Technicians | 1710I1003X | Yes |
Addresses
Primary practice location
2603 Lower Gainsville Rd
Nattc SBT 22
SSC, MS 39529
Mailing address
2603 Lower Gainsville Rd
SBT 22
SSC, MS 39529
Phone (228) 813-4000
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2010. 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.