Provider Demographics
NPI:1609845189
Name:HANKS, WILLIAM EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:EDWARD
Last Name:HANKS
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 1:1207 E HERNDON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3235
Mailing Address - Country:US
Mailing Address - Phone:559-432-4303
Mailing Address - Fax:559-432-4574
Practice Address - Street 1:1207 E HERNDON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3235
Practice Address - Country:US
Practice Address - Phone:559-432-4303
Practice Address - Fax:559-432-4574
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG31359207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA44738Medicare UPIN