NPI 1053592840

William Lowe Waller, MD

Practitioner Dermatology Physician Hattiesburg, MS

Practice location

Address: 3 Thompson Park, Hattiesburg, MS 39401-8202
Phone: (601) 579-3130
Fax: (601) 264-5092
Mailing address: 415 S 28th Ave, Hattiesburg, MS 39401-7246

Registered specialties (2)

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 21371 (MS)

Other Dermatology providers in Mississippi →

Dermatology Physician

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence MD.201654 (LA)

Registry record

NPI: 1053592840
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Nov 2007
Record last updated: 3 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.