Provider Demographics
NPI:1134149248
Name:STRONG, WILLIAM B JR (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:B
Last Name:STRONG
Suffix:JR
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 1:100 FAIRLANE DR
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-2309
Mailing Address - Country:US
Mailing Address - Phone:601-268-3508
Mailing Address - Fax:
Practice Address - Street 1:100 FAIRLANE DR
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-2309
Practice Address - Country:US
Practice Address - Phone:601-268-3508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS07720207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00019234Medicaid
MS640507572WVOtherAMERICAN ADMIN GROUP
MS640507572WVOtherAMERICAN ADMIN GROUP
P00117874OtherRAILROAD MEDICARE
C48231Medicare UPIN