Waller, William Lowe

Waller, William Lowe is an individual health care provider with primary practice located at 3 Thompson Park , Hattiesburg MS 39401-8202. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Waller, William Lowe can be contacted via phone (601) 579-3130.

Contact Information

Primary practice address
3 Thompson Park Hattiesburg MS 39401-8202
Phone: (601) 579-3130
Fax: (601) 264-5092
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X MD.201654 Louisiana
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 21371 Mississippi

Profile Details

NPI number 1053592840
LBN Legal business name Waller, William Lowe
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 20th, 2007
Last updated Aug 3rd, 2020 - about 6 years ago

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 1053592840 NPPES
Mississippi Other 9789697 AETNA
Mississippi MEDICAID 05471708 AETNA

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