Provider Demographics
NPI:1558199547
Name:MCCAIN, WILLIAM C (NP)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:MCCAIN
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 1:196 DRIVE 2258
Mailing Address - Street 2:
Mailing Address - City:SALTILLO
Mailing Address - State:MS
Mailing Address - Zip Code:38866-1801
Mailing Address - Country:US
Mailing Address - Phone:662-552-1956
Mailing Address - Fax:
Practice Address - Street 1:196 DRIVE 2258
Practice Address - Street 2:
Practice Address - City:SALTILLO
Practice Address - State:MS
Practice Address - Zip Code:38866-1801
Practice Address - Country:US
Practice Address - Phone:662-552-1956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906720207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine