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Individual

DR. WILLIAM WALTON MIMS III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1700 SKYLYN DR, SPARTANBURG, SC 29307-1041
(864) 573-3777
(864) 573-3261
Mailing address
PO BOX 30637, CHARLOTTE, NC 28230-0637
(704) 973-5500
(704) 973-5518

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
16145
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16145
STATE MEDICAL BOARD
SC
01
9701066
STATE MEDICAL BOARD
NC
05
Q50203
SC
Enumeration date
02/17/2006
Last updated
04/17/2018
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