Provider Demographics
NPI:1407943848
Name:GIFFORD, WILLIAM PARSONS (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:PARSONS
Last Name:GIFFORD
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 1:1353 GERMANY RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48895-9610
Mailing Address - Country:US
Mailing Address - Phone:517-655-3523
Mailing Address - Fax:
Practice Address - Street 1:1353 GERMANY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:MI
Practice Address - Zip Code:48895-9610
Practice Address - Country:US
Practice Address - Phone:517-655-3523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301040023207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0803317771OtherBCBS INDIVIDUAL PIN
MI4275360Medicaid
MIN42640001Medicare ID - Type Unspecified
MI4275360Medicaid