Provider Demographics
NPI:1477578151
Name:CROW, WILLIAM THOMAS (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:THOMAS
Last Name:CROW
Suffix:
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 1:11101 W COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-2977
Mailing Address - Country:US
Mailing Address - Phone:407-574-2880
Mailing Address - Fax:
Practice Address - Street 1:11101 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-2977
Practice Address - Country:US
Practice Address - Phone:407-574-2880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13483204D00000X
FLOS 9375207Q00000X
TXH4261204D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01560691OtherRAILROAD MEDICARE
FL27146800Medicaid
TX8DP610OtherBCBS
TX127795606Medicaid
FL522882Medicare PIN
TXP01560691OtherRAILROAD MEDICARE
TX8DP610OtherBCBS