Provider Demographics
NPI:1033254263
Name:FOSTER, WILL STERRETT (MD)
Entity Type:Individual
Prefix:DR
First Name:WILL
Middle Name:STERRETT
Last Name:FOSTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:813 CHARLOTTE DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-6720
Mailing Address - Country:US
Mailing Address - Phone:903-236-9653
Mailing Address - Fax:903-236-9653
Practice Address - Street 1:100 E LIBERTY ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1434
Practice Address - Country:US
Practice Address - Phone:502-584-0190
Practice Address - Fax:502-584-0203
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY15493207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYD32246Medicare UPIN