Provider Demographics
NPI:1043298029
Name:QUINN, WILLIAM BRIAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BRIAN
Last Name:QUINN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 N WILSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-1360
Mailing Address - Country:US
Mailing Address - Phone:715-341-1266
Mailing Address - Fax:715-341-1268
Practice Address - Street 1:140 N WILSHIRE DR
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-1360
Practice Address - Country:US
Practice Address - Phone:715-341-1266
Practice Address - Fax:715-341-1268
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI497-025213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI13812OtherSECURITY HEALTH
WI43204800Medicaid
WI27895OtherNETWORK HEALTH INS
WIT63050Medicare UPIN
WI43204800Medicaid