Provider Demographics
NPI:1205947843
Name:STRIEGEL, WILLIAM L (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:L
Last Name:STRIEGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BIENVILLE
Other - Middle Name:MEDICAL
Other - Last Name:CLINIC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:11 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-5709
Mailing Address - Country:US
Mailing Address - Phone:228-266-2208
Mailing Address - Fax:228-875-1335
Practice Address - Street 1:11 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-5709
Practice Address - Country:US
Practice Address - Phone:228-266-2208
Practice Address - Fax:228-875-1335
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS10164174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1639437411OtherBIENVILLE MEDICAL CLINIC (BILLING NPI)
MS00012035Medicaid
MS110203036OtherMEDICARE RR
ME1639437411OtherATHENAHEALTH (BILLING)
MS110203036OtherMEDICARE RR