Provider Demographics
NPI:1164602280
Name:INGLE, WILLIAM L (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:L
Last Name:INGLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N JEBAVY DR
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-1923
Mailing Address - Country:US
Mailing Address - Phone:231-843-4088
Mailing Address - Fax:231-845-2753
Practice Address - Street 1:321 N JEBAVY DR
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-1923
Practice Address - Country:US
Practice Address - Phone:231-843-4088
Practice Address - Fax:231-845-2753
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005648111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950E310490OtherBLUE CROSS BLUE SHIELD
MI2717248Medicaid
MI350038478OtherPALMETTO
MI950E310490OtherBLUE CROSS BLUE SHIELD