Provider Demographics
NPI:1821533001
Name:WILLIAM BELK MD LLC
Entity Type:Organization
Organization Name:WILLIAM BELK MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BELK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-433-6518
Mailing Address - Street 1:3450 OAKMONT DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-6900
Mailing Address - Country:US
Mailing Address - Phone:850-433-6518
Mailing Address - Fax:850-469-0051
Practice Address - Street 1:3450 OAKMONT DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-6900
Practice Address - Country:US
Practice Address - Phone:850-433-6518
Practice Address - Fax:850-469-0051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-27
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME32592207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty