Provider Demographics
NPI:1164469748
Name:EUBANKS, WILLIAM STEVE JR (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:STEVE
Last Name:EUBANKS
Suffix:JR
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 1:2415 N. ORANGE AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804
Mailing Address - Country:US
Mailing Address - Phone:407-303-7399
Mailing Address - Fax:407-303-7305
Practice Address - Street 1:2415 N. ORANGE AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804
Practice Address - Country:US
Practice Address - Phone:407-303-7399
Practice Address - Fax:407-303-7305
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003031774208600000X
FLME0108617208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO185637OtherBLUE SHIELD/BLUE CHOICE
MO208795500Medicaid
MO630763OtherHEALTHLINK
FL003037600Medicaid
MO1701308OtherUNITED HEALTHCARE
FLE1298ZMedicare UPIN
MO208795500Medicaid
MOP00197290Medicare PIN
MO915871108Medicare PIN
MOF75364Medicare UPIN