Provider Demographics
NPI:1609965490
Name:PARTIN, WILLIAM R (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:R
Last Name:PARTIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:700 E SPRING ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-2926
Mailing Address - Country:US
Mailing Address - Phone:912-945-7536
Mailing Address - Fax:812-945-7542
Practice Address - Street 1:700 E SPRING ST
Practice Address - Street 2:SUITE 200
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-2926
Practice Address - Country:US
Practice Address - Phone:912-945-7536
Practice Address - Fax:812-945-7542
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2015-02-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN0105178A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100115990AMedicaid
IN611091357OtherTAX ID
IN200260690Medicaid
INH06243Medicare UPIN
IN200260690Medicaid