Provider Demographics
NPI:1003994013
Name:FEEMAN, WILLIAM E JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:E
Last Name:FEEMAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:640 S WINTERGARDEN RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-3544
Mailing Address - Country:US
Mailing Address - Phone:419-352-4665
Mailing Address - Fax:419-353-0219
Practice Address - Street 1:640 S WINTERGARDEN RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-3544
Practice Address - Country:US
Practice Address - Phone:419-352-4665
Practice Address - Fax:419-353-0219
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032541207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0256771Medicaid
OHA74996Medicare UPIN
OHFE0404093Medicare UPIN