Provider Demographics
NPI:1366042020
Name:ESSEX, WILLIAM R (HIS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:R
Last Name:ESSEX
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 SANTA BARBARA BLVD
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-4333
Mailing Address - Country:US
Mailing Address - Phone:989-915-9391
Mailing Address - Fax:239-673-9509
Practice Address - Street 1:2209 SANTA BARBARA BLVD
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-4333
Practice Address - Country:US
Practice Address - Phone:239-673-9507
Practice Address - Fax:239-673-9509
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist