Provider Demographics
NPI:1013229368
Name:TITSWORTH, WILLIAM LEE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LEE
Last Name:TITSWORTH
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Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:2605 KENTUCKY AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-3800
Mailing Address - Country:US
Mailing Address - Phone:270-415-7653
Mailing Address - Fax:270-575-8359
Practice Address - Street 1:2603 KENTUCKY AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-3814
Practice Address - Country:US
Practice Address - Phone:270-443-6472
Practice Address - Fax:270-442-1649
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2020-12-04
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Provider Licenses
StateLicense IDTaxonomies
FLME113337207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018511900Medicaid
FLIR669ZMedicare PIN