Provider Demographics
NPI:1164459525
Name:SKILES, WILLIAM W (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:W
Last Name:SKILES
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:PO BOX 3395
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47732-3395
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1373 E SR 62
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250
Practice Address - Country:US
Practice Address - Phone:812-801-0130
Practice Address - Fax:812-801-0474
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010475332085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1149722OtherPASSPORT KY MEDICAID
IN200257530Medicaid
300128982OtherMEDICARE RAILROAD
KY2438518000OtherPASSPORT ADVANTAGE
IN000000186943OtherANTHEM
KY64041973Medicaid
4322410OtherAETNA
H28613Medicare UPIN
KY1149722OtherPASSPORT KY MEDICAID
300128982OtherMEDICARE RAILROAD
KY2438518000OtherPASSPORT ADVANTAGE