Park, William Isaiah

Park, William Isaiah is an individual health care provider with primary practice located at 1505 Daphne Ave , Daphne AL 36526-4298. He recently has only one registered license in Allopathic & Osteopathic Physicians / Foot and Ankle Surgery, which is considered as his primary health care specialty. Park, William Isaiah can be contacted via phone (251) 625-2663.

Contact Information

Primary practice address
1505 Daphne Ave Daphne AL 36526-4298
Phone: (251) 625-2663
Fax: (251) 625-3198
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Foot and Ankle Surgery 207XX0004X 00024958 Alabama

Profile Details

NPI number 1780642710
LBN Legal business name Park, William Isaiah
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Aug 23rd, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780642710 NPPES
Mississippi MEDICAID 0126962
Mississippi Other 631187140
Mississippi MEDICAID 051552744
Mississippi Other 051512928
Mississippi Other 200045417

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