Provider Demographics
NPI:1245230549
Name:NOBLE, WILLIAM L (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:L
Last Name:NOBLE
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 1645
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26507-1645
Mailing Address - Country:US
Mailing Address - Phone:304-598-2291
Mailing Address - Fax:304-598-2293
Practice Address - Street 1:99 J D ANDERSON DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-4000
Practice Address - Country:US
Practice Address - Phone:304-598-2291
Practice Address - Fax:304-598-2293
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV111822085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV11052488OtherCAQH
OH0176367Medicaid
PA0007720620006Medicaid
OHP00359305OtherRRMC
PA0007720620002Medicaid
PA0007720620003Medicaid
WV1036220OtherWORKERS COMP PIN NUMBER
WV0123006000Medicaid
WV0123006000Medicaid
WV0636772Medicare PIN
WV1036220OtherWORKERS COMP PIN NUMBER
OH4197521Medicare PIN