Provider Demographics
NPI:1518267913
Name:WILLIAM A. INGRAM, MD, PC
Entity Type:Organization
Organization Name:WILLIAM A. INGRAM, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:INGRAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-991-1975
Mailing Address - Street 1:18015 OAK ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-6097
Mailing Address - Country:US
Mailing Address - Phone:402-991-1975
Mailing Address - Fax:402-991-1974
Practice Address - Street 1:18015 OAK ST
Practice Address - Street 2:SUITE B
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-6097
Practice Address - Country:US
Practice Address - Phone:402-991-1975
Practice Address - Fax:402-991-1974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty