Provider Demographics
NPI:1467453589
Name:DETORRES, WILLIAM J III (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:DETORRES
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6604 STATE HIGHWAY 56
Mailing Address - Street 2:
Mailing Address - City:POTSDAM
Mailing Address - State:NY
Mailing Address - Zip Code:13676-3545
Mailing Address - Country:US
Mailing Address - Phone:315-261-4777
Mailing Address - Fax:315-261-4779
Practice Address - Street 1:6604 STATE HIGHWAY 56
Practice Address - Street 2:
Practice Address - City:POTSDAM
Practice Address - State:NY
Practice Address - Zip Code:13676-3545
Practice Address - Country:US
Practice Address - Phone:315-261-4777
Practice Address - Fax:315-261-4779
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2008-09-08
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Provider Licenses
StateLicense IDTaxonomies
NY187115207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F59792Medicare UPIN
NYRA0660Medicare PIN
NY759792Medicare UPIN