Provider Demographics
NPI:1760434203
Name:DENHAM, WILLIAM CRAIG (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CRAIG
Last Name:DENHAM
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 550
Mailing Address - Street 2:
Mailing Address - City:VANCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41179-0550
Mailing Address - Country:US
Mailing Address - Phone:606-759-0002
Mailing Address - Fax:
Practice Address - Street 1:525 TUCKER DR
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-9182
Practice Address - Country:US
Practice Address - Phone:606-759-0002
Practice Address - Fax:606-759-0103
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39526207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2663658Medicaid
KY64117773Medicaid
OH2663658Medicaid
KY00019001Medicare PIN