Provider Demographics
NPI:1306847009
Name:SCHENK, WILLIAM D
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:D
Last Name:SCHENK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1670 W MAIN ST
Mailing Address - Street 2:STE100
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-1344
Mailing Address - Country:US
Mailing Address - Phone:615-444-4516
Mailing Address - Fax:
Practice Address - Street 1:1670 W MAIN ST
Practice Address - Street 2:STE 100
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-1344
Practice Address - Country:US
Practice Address - Phone:615-453-5155
Practice Address - Fax:615-444-5915
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16211207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN180003265OtherPALMETTO GBA
TN000047586OtherBLUE CROSS BLUE SHIELD
TN3013671OtherHEALTHSPRING
TN000047586OtherTENNCARE SELECT
TN1238610001OtherDMERC
TN000047586OtherBCBS ADVANTAGE
TN3180072OtherCIGNA
TN3013671Medicaid
TN4065477OtherAETNA PPO
TN621298175OtherDEFAULT
TN000047586OtherTENNCARE SELECT
TN3013671Medicaid