Provider Demographics
NPI:1407811862
Name:FALLON, WILLIAM F (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:F
Last Name:FALLON
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 1:525 E MARKET ST
Mailing Address - Street 2:ANNEX 3
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1619
Mailing Address - Country:US
Mailing Address - Phone:330-375-7512
Mailing Address - Fax:330-375-3445
Practice Address - Street 1:550 E MARKET ST
Practice Address - Street 2:SUITE 103
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1613
Practice Address - Country:US
Practice Address - Phone:330-434-5978
Practice Address - Fax:330-434-6908
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-065116F2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0926092Medicaid
D52477Medicare UPIN
OH0926092Medicaid