Provider Demographics
NPI:1780705194
Name:GHEE, WILLIAM THEOTIS (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:THEOTIS
Last Name:GHEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 102101
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2101
Mailing Address - Country:US
Mailing Address - Phone:863-603-6565
Mailing Address - Fax:863-603-6576
Practice Address - Street 1:3525 LAKELAND HILLS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-1965
Practice Address - Country:US
Practice Address - Phone:863-603-6565
Practice Address - Fax:863-603-6576
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00516282085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDA5786OtherMEDICARE RR GROUP # / LAKELAND REGIONAL HEALTH SYSTEMS, INC
FL1497748743OtherNPI GROUP # / LAKELAND REGIONAL HEALTH SYSTEMS, INC
FL1497748743OtherNPI GROUP # / LAKELAND REGIONAL HEALTH SYSTEMS, INC
FLDA5786OtherMEDICARE RR GROUP # / LAKELAND REGIONAL HEALTH SYSTEMS, INC