Provider Demographics
NPI:1861277964
Name:QUINN, WILLIAM FOWLER (NP)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:FOWLER
Last Name:QUINN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 HIGHWAY 2
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-7954
Mailing Address - Country:US
Mailing Address - Phone:662-286-0909
Mailing Address - Fax:662-286-0110
Practice Address - Street 1:820 HIGHWAY 2
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-7954
Practice Address - Country:US
Practice Address - Phone:662-286-0909
Practice Address - Fax:662-286-0110
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS909811363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner