Provider Demographics
NPI:1881690501
Name:BARTLOW, WILLIAM P (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:P
Last Name:BARTLOW
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 209
Mailing Address - Street 2:
Mailing Address - City:MUNCY
Mailing Address - State:PA
Mailing Address - Zip Code:17756-0209
Mailing Address - Country:US
Mailing Address - Phone:570-546-8255
Mailing Address - Fax:570-546-3668
Practice Address - Street 1:151 JOHN BRADY DR
Practice Address - Street 2:STE 4
Practice Address - City:PENNSDALE
Practice Address - State:PA
Practice Address - Zip Code:17756-8425
Practice Address - Country:US
Practice Address - Phone:570-546-8255
Practice Address - Fax:570-546-3668
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD033946E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC33025Medicare UPIN