Provider Demographics
NPI:1548753023
Name:O'HEARN, WILLIAM STEPHEN III (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:STEPHEN
Last Name:O'HEARN
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:826 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-3182
Mailing Address - Country:US
Mailing Address - Phone:860-235-6512
Mailing Address - Fax:
Practice Address - Street 1:1102 S VIRGINIA ST # SR
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-3579
Practice Address - Country:US
Practice Address - Phone:270-632-6741
Practice Address - Fax:270-637-6742
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2021-10-05
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Provider Licenses
StateLicense IDTaxonomies
390200000X
KY54094207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program