Individual
MR. WILLIAM C RENFROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 HEIGHTS DR, CLINTON, MS 39056-6602
(601) 826-4173
Mailing address
110 HEIGHTS DR, CLINTON, MS 39056-6602
(601) 826-4173
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R869514
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08552207
MS MEDICAID
MS
Enumeration date
08/31/2006
Last updated
11/04/2013
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