Provider Demographics
NPI:1013093574
Name:DILLON, WILLIAM I (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:I
Last Name:DILLON
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 1:1037 CONNEAUT AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-5301
Mailing Address - Country:US
Mailing Address - Phone:419-373-6046
Mailing Address - Fax:419-352-9048
Practice Address - Street 1:1037 CONNEAUT AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-5301
Practice Address - Country:US
Practice Address - Phone:419-373-6046
Practice Address - Fax:419-352-9048
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2008-05-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35064057D207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1013093574OtherRAILROAD MEDICARE
OH1013093574OtherMEDICAL MUTUAL OF OHIO
OH1013093574OtherFRONTPATH HEALTH COALITION
OH1013093574OtherHEALTH REACH
OH1013093574OtherHEALTH REACH
OHF40805Medicare UPIN