Provider Demographics
NPI:1528043056
Name:AESCHLIMAN, WILLIAM J (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:AESCHLIMAN
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 1:1234 E DUPONT RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-1545
Mailing Address - Country:US
Mailing Address - Phone:260-373-9700
Mailing Address - Fax:260-373-9740
Practice Address - Street 1:10515 ILLINOIS RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46814-9182
Practice Address - Country:US
Practice Address - Phone:260-373-9200
Practice Address - Fax:260-373-9219
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01026984A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000239210 10OtherUNITED HEALTHCARE
4204133OtherAETNA
IN000000111792OtherANTHEM
IN100354510Medicaid
IN1015OtherPHYSICIANS HEALTH PLAN
IN3937240015OtherMEDICARE DMEPOS
00000239210 10OtherUNITED HEALTHCARE
B28129Medicare UPIN
IN069880AMedicare ID - Type Unspecified
080130044Medicare ID - Type UnspecifiedRAILROAD MEDICARE
IN100354510Medicaid