Provider Demographics
NPI:1184695868
Name:KERR, WILLIAM ARCHIBALD (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ARCHIBALD
Last Name:KERR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:850 N CENTER AVE
Mailing Address - Street 2:STE 3B
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-1682
Mailing Address - Country:US
Mailing Address - Phone:989-731-0658
Mailing Address - Fax:989-731-0681
Practice Address - Street 1:850 N CENTER AVE
Practice Address - Street 2:STE 3B
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-1682
Practice Address - Country:US
Practice Address - Phone:989-731-0658
Practice Address - Fax:989-731-0681
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301064515207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0806907210OtherBCBS
0806907210OtherBCBS
F88857Medicare UPIN