Provider Demographics
NPI:1477578664
Name:IRWIN, WILLIAM L II (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:L
Last Name:IRWIN
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5283 S 225 E
Mailing Address - Street 2:
Mailing Address - City:CUTLER
Mailing Address - State:IN
Mailing Address - Zip Code:46920-9367
Mailing Address - Country:US
Mailing Address - Phone:317-501-4637
Mailing Address - Fax:
Practice Address - Street 1:5283 S 225 E
Practice Address - Street 2:
Practice Address - City:CUTLER
Practice Address - State:IN
Practice Address - Zip Code:46920-9367
Practice Address - Country:US
Practice Address - Phone:317-501-4637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01036166A208D00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN235200CMedicare ID - Type Unspecified