Organization Active NPI

William R. Fellows, MD

  • Addiction Medicine (Internal Medicine) Physician
  • Biloxi, MS
National Provider Identifier
1306840871
Registry record updated Sep 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
08239 Issued in MS
Legal business name
WILLIAM R. FELLOWS, MD
Practice address
180 Debuys Rd
Ste 130
Biloxi, MS 39531-4402
Phone
(228) 388-7770
NPI assigned
Jun 11, 2005
Last updated
Sep 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William R Fellows, M.D.
Title
Owner
Phone
(228) 388-7770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RA0401X 08239 MS Primary

Addresses

Primary practice location

180 Debuys Rd
Ste 130
Biloxi, MS 39531-4402

Mailing address

180 Debuys Rd
Ste 130
Biloxi, MS 39531-4402
Phone (228) 388-7770

Other identifiers 1

IdentifierTypeStateIssuer
03109765MedicaidMS

National Provider Directory

National Provider Directory

Locations

180 Debuys Rd
Ste 130
Biloxi, MS 39531
Phone (228) 388-7770

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221004800000",
    "number": "1306840871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 DEBUYS RD",
            "address_2": "STE 130",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395314402",
            "telephone_number": "228-388-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 DEBUYS RD",
            "address_2": "STE 130",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395314402",
            "telephone_number": "228-388-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM R. FELLOWS, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-11",
        "last_updated": "2008-09-10",
        "status": "A",
        "authorized_official_last_name": "FELLOWS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-388-7770",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "MS",
            "license": "08239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03109765",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.