Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 13115 | SC |
NPI | 1003986514 |
---|---|
Provider Name | William L. Mills |
First Address | Conway, SC 29526-8995 |
Second Address | Conway, SC 29526-8995 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 20/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E59804 | (02) | SC |