Provider Demographics
NPI:1538216239
Name:HURD, WILLIAM C (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:HURD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:220 S CLAYBROOK ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3538
Mailing Address - Country:US
Mailing Address - Phone:901-276-4844
Mailing Address - Fax:901-276-0926
Practice Address - Street 1:220 S CLAYBROOK ST STE 101
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3538
Practice Address - Country:US
Practice Address - Phone:901-276-4844
Practice Address - Fax:901-276-0926
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS12279207W00000X
TN0013888207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0015522Medicaid
TN3005071Medicaid
TN3005071Medicare ID - Type Unspecified
MS0015522Medicaid