Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | ME143983 | FL |
N | 207PE0004X | Emergency Medical Services | ME143983 | FL |
NPI | 1174064380 |
---|---|
Provider Name | Dr. William David Nimmons |
First Address | Tallahassee, FL 32308-5352 |
Second Address | Tallahassee, FL 32308-5054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2017 |
Last Update Date | 29/04/2021 |