Provider Demographics
NPI:1578673919
Name:STINSON, WILLIAM DAVID (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DAVID
Last Name:STINSON
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 1:315 WALNUT BEND SOUTH
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-7216
Mailing Address - Country:US
Mailing Address - Phone:901-755-8880
Mailing Address - Fax:901-755-8366
Practice Address - Street 1:315 WALNUT BEND SOUTH
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-7216
Practice Address - Country:US
Practice Address - Phone:901-755-8880
Practice Address - Fax:901-755-8366
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30219207V00000X
TNBS5820457207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3142607Medicare PIN
TNG75221Medicare UPIN