Provider Demographics
NPI:1952328478
Name:POIRIER, WILLIAM THOMAS (MD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:THOMAS
Last Name:POIRIER
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 1:202 GOLD CIR
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-4343
Mailing Address - Country:US
Mailing Address - Phone:916-778-9421
Mailing Address - Fax:310-263-0100
Practice Address - Street 1:1600 SACRAMENTO INN WAY
Practice Address - Street 2:SUITE 116
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-3457
Practice Address - Country:US
Practice Address - Phone:916-564-5515
Practice Address - Fax:916-564-5553
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG73756208D00000X, 207YX0901X, 207YX0905X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A58798Medicare UPIN