Individual
WILLIAM ALTON SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
213 CALDWELL DR, HAZLEHURST, MS 39083-2711
(601) 894-4661
Mailing address
1004 CHURCH ST, WESSON, MS 39191-8914
(601) 643-5808
(601) 643-5808
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902208
MS
Other
Enumeration date
11/15/2017
Last updated
11/15/2017
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