Provider Demographics
NPI:1588619431
Name:ACREE, WILLIAM BENJAMIN (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BENJAMIN
Last Name:ACREE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S 25TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-4316
Mailing Address - Country:US
Mailing Address - Phone:515-955-7724
Mailing Address - Fax:515-955-8593
Practice Address - Street 1:300 S 25TH ST
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-4316
Practice Address - Country:US
Practice Address - Phone:515-955-7724
Practice Address - Fax:515-955-8593
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06740111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA249419OtherMIDLAND'S CHOICE #
IA06183OtherBLUE SHIELD PROVIDER #
IA06183OtherALLIANCE SELECT PROVIDER
IA06183OtherALLIANCE SELECT PROVIDER
IAU84620Medicare UPIN
IAI16959Medicare ID - Type UnspecifiedPROVIDER IDENTIFICATION #