Provider Demographics
NPI:1154477446
Name:WILLIAM C EARLY MD PA
Entity Type:Organization
Organization Name:WILLIAM C EARLY MD PA
Other - Org Name:WILLIAM C EARLY MD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:EARLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-741-7577
Mailing Address - Street 1:8302 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-7308
Mailing Address - Country:US
Mailing Address - Phone:954-741-7577
Mailing Address - Fax:954-741-9440
Practice Address - Street 1:8302 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7308
Practice Address - Country:US
Practice Address - Phone:954-741-7577
Practice Address - Fax:954-741-9440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME40323207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAB047Medicare PIN