Provider Demographics
NPI:1720257736
Name:BILL D WEBB PSC
Entity Type:Organization
Organization Name:BILL D WEBB PSC
Other - Org Name:DR.BILLD.WEBB, PSC
Other - Org Type:Other Name
Authorized Official - Title/Position:CERTIFIED PARAOPTOMETRIC ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:CPOA
Authorized Official - Phone:270-726-2434
Mailing Address - Street 1:PO BOX 415
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42276-0415
Mailing Address - Country:US
Mailing Address - Phone:270-726-2434
Mailing Address - Fax:270-726-2435
Practice Address - Street 1:603 E 4TH ST
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:KY
Practice Address - Zip Code:42276-1857
Practice Address - Country:US
Practice Address - Phone:270-726-2434
Practice Address - Fax:270-726-2435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-23
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY716DT332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0208630001Medicare NSC