Provider Demographics
NPI:1477507739
Name:MCCUTCHEN, WILLIAM III (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:MCCUTCHEN
Suffix:III
Gender:M
Credentials:DO
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 100523
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-0523
Mailing Address - Country:US
Mailing Address - Phone:843-669-5162
Mailing Address - Fax:843-667-4573
Practice Address - Street 1:410 UNIVERSITY PKWY
Practice Address - Street 2:SUITE 2360
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-6810
Practice Address - Country:US
Practice Address - Phone:803-642-6500
Practice Address - Fax:803-649-7551
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-01619207L00000X
MI5101014673207L00000X
SC974207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902273Medicaid
SCN0161AMedicaid
SCN0161AMedicaid
SCAA29786573Medicare PIN
NC2048585Medicare PIN