Basic Information
Provider Information | |||||||||
NPI: | 1265690580 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | MAYS | ||||||||
FirstName: | WILLIAM | ||||||||
MiddleName: | HAYWOOD | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: | III | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 4174 MINDEN RD | ||||||||
Address2: |   | ||||||||
City: | MEMPHIS | ||||||||
State: | TN | ||||||||
PostalCode: | 381171606 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9016475394 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 1265 UNION AVE | ||||||||
Address2: |   | ||||||||
City: | MEMPHIS | ||||||||
State: | TN | ||||||||
PostalCode: | 381043415 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9015162312 | ||||||||
FaxNumber: | 9015167395 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/23/2008 | ||||||||
LastUpdateDate: | 06/27/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 06/27/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | E-12952 | AR | N |   | Allopathic & Osteopathic Physicians | Emergency Medicine |   | 207P00000X | 57627 | TN | N |   | Allopathic & Osteopathic Physicians | Emergency Medicine |   | 208600000X | 0101251924 | VA | N |   | Allopathic & Osteopathic Physicians | Surgery |   | 2084N0400X | 57627 | TN | Y |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.