Provider Demographics
NPI:1366824732
Name:SHEPPARD, WILLIAM
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:SHEPPARD
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 1:3325 BROWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-2722
Mailing Address - Country:US
Mailing Address - Phone:412-884-6238
Mailing Address - Fax:
Practice Address - Street 1:2400 ARDMORE BLVD
Practice Address - Street 2:SUITE 700
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-5299
Practice Address - Country:US
Practice Address - Phone:412-436-1320
Practice Address - Fax:412-235-1343
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT000281E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist