Provider Demographics
NPI:1124017744
Name:HANDY, WILLIAM M (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:M
Last Name:HANDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 FALLS DR NW
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-8093
Mailing Address - Country:US
Mailing Address - Phone:276-623-0740
Mailing Address - Fax:276-623-0660
Practice Address - Street 1:389 FALLS NWDR
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-8093
Practice Address - Country:US
Practice Address - Phone:276-623-0740
Practice Address - Fax:276-623-0660
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101050255207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA187201OtherANTHEM BC/BS
VAP00273147OtherRR MEDICARE
VA010226627Medicaid
G07212Medicare UPIN
VA187201OtherANTHEM BC/BS