Provider Demographics
NPI:1710279393
Name:PACE, WILLIAM BRANDON (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BRANDON
Last Name:PACE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:222 MEDICAL CIR
Mailing Address - Street 2:ST. CLAIRE REGIONAL MEDICAL CENTER
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-1179
Mailing Address - Country:US
Mailing Address - Phone:606-783-6611
Mailing Address - Fax:606-783-6611
Practice Address - Street 1:222 MEDICAL CIR
Practice Address - Street 2:ST. CLAIRE REGIONAL MEDICAL CENTER
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-1179
Practice Address - Country:US
Practice Address - Phone:606-783-6611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY47193207P00000X
KYR2605207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine