Provider Demographics
NPI:1700857604
Name:PAO, WILLIAM (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:PAO
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 PIERCE AVE
Mailing Address - Street 2:777 PRESTON RESEARCH BUILDING
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0021
Mailing Address - Country:US
Mailing Address - Phone:615-936-3831
Mailing Address - Fax:615-343-7602
Practice Address - Street 1:2220 PIERCE AVE
Practice Address - Street 2:777 PRESTON RESEARCH BUILDING
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0021
Practice Address - Country:US
Practice Address - Phone:615-936-3831
Practice Address - Fax:615-343-7602
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44440207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I20996Medicare UPIN
0106K1Medicare ID - Type Unspecified