Provider Demographics
NPI:1467428854
Name:SCHWARTZ, WILLIAM J III
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:SCHWARTZ
Suffix:III
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 2699
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2699
Mailing Address - Country:US
Mailing Address - Phone:850-475-4686
Mailing Address - Fax:850-475-4619
Practice Address - Street 1:5153 N 9TH AVE
Practice Address - Street 2:201
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8785
Practice Address - Country:US
Practice Address - Phone:850-416-2477
Practice Address - Fax:850-416-7520
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-24309207VM0101X
FLME119179207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100292000BMedicaid
MO202441333Medicaid
MO1467428854Medicaid
MOE941742AMedicare PIN
KSE73974Medicare UPIN
MOP00792375Medicare PIN
MOP00792396Medicare PIN
MOMA1812004Medicare PIN
KSE94A00001Medicare PIN
MO1467428854Medicaid