Provider Demographics
NPI:1578586293
Name:FLYNN, WILLIAM J (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:FLYNN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 8000 DEPT 313
Mailing Address - Street 2:UNIVERSITY AT BUFFALO SURGEONS, INC
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14267-0002
Mailing Address - Country:US
Mailing Address - Phone:716-888-4889
Mailing Address - Fax:716-849-5620
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:DEPT OF SURGERY
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3021
Practice Address - Country:US
Practice Address - Phone:716-898-5186
Practice Address - Fax:716-898-3194
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2014-03-26
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Provider Licenses
StateLicense IDTaxonomies
NY161806208600000X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01260851Medicaid
DD2311Medicare ID - Type UnspecifiedMEDICARE
NY01260851Medicaid