Provider Demographics
NPI:1124018908
Name:ATKINSON, BILL (MD)
Entity Type:Individual
Prefix:
First Name:BILL
Middle Name:
Last Name:ATKINSON
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 1:4904 116TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-7600
Mailing Address - Country:US
Mailing Address - Phone:806-441-9529
Mailing Address - Fax:806-723-6532
Practice Address - Street 1:4102 24TH ST
Practice Address - Street 2:STE 300
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1806
Practice Address - Country:US
Practice Address - Phone:806-725-5497
Practice Address - Fax:806-723-6299
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3121207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM36807OtherPRESBYTERIAN COMMERCIAL
NM36807Medicaid
OK100150770AMedicaid
TX128708806Medicaid
TX128708807Medicaid
NMX6909Medicaid
TX80832ZOtherHMO BLUE
TX100108103Medicaid
NMA598OtherTRIWEST
TX83G030OtherBC/BS
TX100108102OtherFIRSTCARE COMMERCIAL
TX128708803Medicaid
TX60061447OtherDPS
TXBA0260872OtherDEA
TX83G030Medicare ID - Type Unspecified
TX100108103Medicaid
TXBA0260872OtherDEA
NMA598OtherTRIWEST