Provider Demographics
NPI:1134112097
Name:BARTLEY, WILLIAM RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RAY
Last Name:BARTLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:660 MASON RIDGE CENTER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8512
Mailing Address - Country:US
Mailing Address - Phone:314-448-3791
Mailing Address - Fax:314-996-7658
Practice Address - Street 1:1 PROFESSIONAL DR
Practice Address - Street 2:SUITE 220
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-5068
Practice Address - Country:US
Practice Address - Phone:618-463-8626
Practice Address - Fax:618-463-8688
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-071248207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine