Provider Demographics
NPI:1700879665
Name:KISER, WILLIAM DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DAVID
Last Name:KISER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-4122
Mailing Address - Country:US
Mailing Address - Phone:276-783-6131
Mailing Address - Fax:276-783-1953
Practice Address - Street 1:1128 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-4122
Practice Address - Country:US
Practice Address - Phone:276-783-6131
Practice Address - Fax:276-783-1953
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034112207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA180039996OtherRAILROAD MEDICARE
VA006306632Medicaid
VA180000794Medicare PIN
VA180039996OtherRAILROAD MEDICARE
VA006306632Medicaid