Provider Demographics
NPI:1508889817
Name:SHAPPLEY, WILLIAM V (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:V
Last Name:SHAPPLEY
Suffix:
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 1:7705 POPLAR AVE
Mailing Address - Street 2:SUITE 310B
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3930
Mailing Address - Country:US
Mailing Address - Phone:901-759-0101
Mailing Address - Fax:901-759-1588
Practice Address - Street 1:7705 POPLAR AVE
Practice Address - Street 2:SUITE 310B
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3930
Practice Address - Country:US
Practice Address - Phone:901-759-0101
Practice Address - Fax:901-759-1588
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3158201Medicare ID - Type Unspecified
TNB59268Medicare UPIN