William E. Middleton Jr., D.D.S.
Individual provider Active NPI Dentist · Horn Lake, MS
NPI 1497901417 · NPPES record last updated Aug 10, 2008
Key facts
- NPI
- 1497901417
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2592-90 (MS)
- Practice address
- 3011 Goodman Rd W
Horn Lake, MS 38637-1103 - Phone
- (662) 342-6530
- Fax
- (662) 342-9098
- NPI assigned
- Aug 10, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2592-90 | MS | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William E Middleton Jr DDS PA | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2592-90 | MS | Yes |
Addresses
Primary practice location
3011 Goodman Rd W
Horn Lake, MS 38637-1103
Mailing address
3011 Goodman Rd W
Horn Lake, MS 38637-1103
Phone (662) 342-6530
Other providers in Horn Lake, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2008. 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.