Provider Demographics
NPI:1710950308
Name:DOSS, WILLIAM LAFAYETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LAFAYETTE
Last Name:DOSS
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:PO BOX 751069
Mailing Address - Street 2:ECU PHYSICIANS
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 MOYE BLVD
Practice Address - Street 2:ECU PHYSICIANS PHYSICAL MEDICINE & REHABILITATION
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4300
Practice Address - Country:US
Practice Address - Phone:252-847-6600
Practice Address - Fax:252-847-2204
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053048208100000X
ARE-6256208100000X, 2081P2900X
NC9501527208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA-017OtherTRICARE/CHAMPUS
VAPAROtherMULTIPLAN
10007082OtherSENTARA/OPTIMA
VA60453OtherSENTARA OPTIMA
VA006803237Medicaid
NC05904OtherBCBSNC
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
NC05904OtherMEDICAID BC BS
VAPAROtherUSA MANAGED CARE
VAPAROtherCORVEL/CORCARE
VAPAROtherCIGNA
VAPAROtherAETNA
VAPAROtherVIRGINIA HEALTH NETWORK
VA278149OtherANTHEM BC BS
NC7905904Medicaid
932610OtherUHC/MAMSI
VAPAROtherCIGNA
NCNC9215AMedicare PIN
VAPAROtherVIRGINIA HEALTH NETWORK
932610OtherUHC/MAMSI
VA000828E82Medicare PIN