Provider Demographics
NPI:1801845060
Name:MEYER, WILLIAM H (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:MEYER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1075 HAWTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39648-7568
Mailing Address - Country:US
Mailing Address - Phone:601-835-9468
Mailing Address - Fax:601-878-2011
Practice Address - Street 1:427 HIGHWAY 51 N
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:MS
Practice Address - Zip Code:39601-2350
Practice Address - Country:US
Practice Address - Phone:601-835-9468
Practice Address - Fax:601-878-2011
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2009-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS05473207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00014937Medicaid
MS512I200056Medicare PIN
MSB30126Medicare UPIN