Provider Demographics
NPI:1689626459
Name:FLANAGAN, WILLIAM FRANCIS
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FRANCIS
Last Name:FLANAGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:FRANCIS
Other - Last Name:FLANAGAN
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-2286
Mailing Address - Fax:864-797-6198
Practice Address - Street 1:8 MEMORIAL MEDICAL CT
Practice Address - Street 2:STE.6
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4455
Practice Address - Country:US
Practice Address - Phone:864-295-1031
Practice Address - Fax:864-269-1639
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC15432208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC470587Medicaid
SC4200Medicare ID - Type Unspecified
SC470587Medicaid