Provider Demographics
NPI:1245281005
Name:MORRISSETTE, WILLIAM PHILIP III (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:PHILIP
Last Name:MORRISSETTE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:15769 WC MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-7327
Mailing Address - Country:US
Mailing Address - Phone:804-419-9701
Mailing Address - Fax:804-378-9143
Practice Address - Street 1:15769 WC MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-7327
Practice Address - Country:US
Practice Address - Phone:804-419-9701
Practice Address - Fax:804-378-9143
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101030146207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10002817OtherOPTIMA
VA540883363OtherPHCS
VA540883363OtherVIRGINIA HEALTH NETWORK
VA82533OtherSOUTHERN HEALTH
VI540883363OtherCHAMPUS-TRICARE
VA10529OtherCIGNA
VA5633869Medicaid
VA116045OtherANTHEM
VI540883363OtherPREFERRED CARE
VA0100409OtherUNITED HEALTHCARE
VA540883363OtherGREAT WEST HEALTHCARE
VA856751OtherMAMSI
VA539779OtherAETNA
VA540883363OtherFIRST HEALTH
VA016525V28Medicare PIN
VI540883363OtherPREFERRED CARE
VA82533OtherSOUTHERN HEALTH
VA10002817OtherOPTIMA
VA540883363OtherPHCS
VAC47609Medicare UPIN