Basic Information
Provider Information
NPI: 1013321546
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRICKLAND
FirstName: WILLIAM
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 6069
Address2:  
City: WEST COLUMBIA
State: SC
PostalCode: 291716069
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3799 12TH STREET EXT STE 105
Address2:  
City: CAYCE
State: SC
PostalCode: 290333750
CountryCode: US
TelephoneNumber: 8039266820
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/12/2014
LastUpdateDate: 11/11/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XLL36928SCN Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000X36928SCY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home