Provider Demographics
NPI:1437140464
Name:OVERHOLSER, WILLIAM H
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:OVERHOLSER
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:PO BOX 1821
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43702-1821
Mailing Address - Country:US
Mailing Address - Phone:740-455-9788
Mailing Address - Fax:740-455-3686
Practice Address - Street 1:1 E MAIN ST
Practice Address - Street 2:SUITE 100A
Practice Address - City:NEW CONCORD
Practice Address - State:OH
Practice Address - Zip Code:43762-1214
Practice Address - Country:US
Practice Address - Phone:740-826-7621
Practice Address - Fax:740-826-1112
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35033712-O207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0229756Medicaid
OH0229756Medicaid