Provider Demographics
NPI:1437595675
Name:STILLWELL, WILLIAM THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:THOMAS
Last Name:STILLWELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4044 W LAKE MARY BLVD
Mailing Address - Street 2:#104-345
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2012
Mailing Address - Country:US
Mailing Address - Phone:407-455-2555
Mailing Address - Fax:407-333-1071
Practice Address - Street 1:4044 W LAKE MARY BLVD
Practice Address - Street 2:#104-345
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2012
Practice Address - Country:US
Practice Address - Phone:407-455-2555
Practice Address - Fax:407-333-1071
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME89370207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery