Provider Demographics
NPI:1609823392
Name:STINSON, WILLIAM GREGORY (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM GREGORY
Middle Name:
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 1:75 HERRICK ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-5903
Mailing Address - Country:US
Mailing Address - Phone:978-922-1390
Mailing Address - Fax:
Practice Address - Street 1:75 HERRICK ST
Practice Address - Street 2:SUITE 215
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-5903
Practice Address - Country:US
Practice Address - Phone:978-922-1390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA73674207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology