Provider Demographics
NPI:1386658367
Name:BURROW, WILLIAM HOLLIS II (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HOLLIS
Last Name:BURROW
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 TREETOPS BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-7645
Mailing Address - Country:US
Mailing Address - Phone:601-939-0005
Mailing Address - Fax:601-936-4949
Practice Address - Street 1:1006 TREETOPS BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-7645
Practice Address - Country:US
Practice Address - Phone:601-939-0005
Practice Address - Fax:601-936-4949
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS06705174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSC48271Medicare UPIN
MS070016829Medicare PIN
MS070000090Medicare PIN