Provider Demographics
NPI:1215931738
Name:MAYO, WILLIAM SUMNERS (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SUMNERS
Last Name:MAYO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1520
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-1520
Mailing Address - Country:US
Mailing Address - Phone:662-234-3937
Mailing Address - Fax:662-234-3898
Practice Address - Street 1:1628 HIGHWAY 30 EAST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5347
Practice Address - Country:US
Practice Address - Phone:662-234-3937
Practice Address - Fax:662-234-3898
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS09636207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00116970Medicaid
MS180000151Medicare PIN
MSD00699Medicare UPIN